Pericardial decompression syndrome: A comprehensive review

Figure 3 Pericardial decompression syndrome. Following the rapid removal of the pericardial fluid originally compressing the right sided chambers during tamponade, may lead to an increased venous return causing significant right ventricular expansion at the expense of the left chamber resulting in the reduced left ventricle volume/output and thus ensuing decompensated left heart failure and/or pulmonary edema. The rapid tamponade release is also followed by a net increase in the pulmonary venous return (left ventricular preload) while adaptive systemic vascular resistance (after-load) being still high and may result in preload/afterload mismatch thus precipitating an acute onset heart failure.