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We present a case of a 43-year-old woman with a history of chronic idiopathic pericardial
effusion, which has been diagnosed 6 years ago. The patient reported an increasing
dyspnea over the last 2 months. Echocardiographic examination showed a massive pericardial
effusion with compromise of the right atrium and ventricle, and an increase in the
respiratory variation of mitral valve inflow velocities, suggested of haemodynamic
compromise. A therapeutic pericardiocentesis was performed using a subxyphoidal approach.
Five hundred millilitres of serous fluid were drained and a marked reduction of the
effusion was achieved. On day 1 after the pericardiocentesis, the patient developed
a left sided chest pain. The chest radiography showed a new lucent outline around
the heart representing the existence of air in the pericardial space (Fig. 1).
Fig. 1Chest radiography showed an abnormal shadow under the pericardium suggesting a band
of gas surrounding the cardiac silhouette.
