• Andrew Curiale, Srilakshmi Vallabhaneni, Santo Longo, and Jamshid Shirani.
• Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA.
• Echocardiography. 2021 Aug 1; 38 (8): 1471-1473.

BackgroundPericardial decompression syndrome (PDS) is defined as paradoxical hemodynamic deterioration associated with left, right, or bi-ventricular dilation and systolic dysfunction following pericardiocentesis. It is uncommon yet under-recognized, underreported, and associated with significant morbidity and mortality.Case ReportWe report a unique case of PDS associated with left ventricular (LV) systolic dysfunction and massive apical thrombosis following surgical removal of 800 ml of pericardial fluid in a 72-year-old man with undiagnosed lung cancer. Treatment with anticoagulation and anti-remodeling medications resulted in complete resolution of the thrombus and recovery of LV function.ConclusionsPDS, although rare, can lead to significant morbidity and mortality. Left ventricular apical thrombosis could result from PDS in the setting of hypercoagulable state. Treatment of the underlying disease may lead to successful resolution of PDS and its complications.© 2021 Wiley Periodicals LLC.

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