Left ventricular diastolic collapse and late regional cardiac tamponade postcardiac surgery caused by large left pleural effusion.

Cardiac tamponade is a well-recognized early complication (ie, within 15 days) of cardiac surgery usually a result of the development of a pericardial effusion postoperatively. However, left ventricular diastolic collapse as a result of the presence of a large pleural effusion, but in the absence of any pericardial effusion, is rare, particularly late (ie, after 15 days) after cardiac surgery. We present the echocardiographic findings of a man presenting with recurrent exertional breathlessness, after elective tissue aortic valve replacement, and demonstrate, by echocardiography, the mechanism of left ventricular diastolic collapse and late regional cardiac tamponade, after cardiac surgery, as a result of the effects of a large pleural effusion but in the absence of any pericardial effusion. We discuss and review the literature on this phenomenon.