Right ventricular diastolic collapse without hemodynamic compromise in a patient with large, bilateral pleural effusions

A 22-year-old woman was admitted to the hospital with large bilateral pleuraleffusions and venous thromboembolism. Echocardiography revealed right ventricular diastolic collapse (RVDC) without physical signs of cardiac tamponade. This echocardiographic abnormality disappeared after thoracentesis. The results of this case report would suggest that pleural effusions were responsible for the echocardiographic finding of RVDC. Presence of RVDC in patients without clinical evidence of cardiac tamponade should alert physicians to look for pleural effusion. Echocardiographic reevaluation after thoracentesis should precede pericardiocentesis.