Skip to main content Accessibility help

Massive pericardial effusion with left-to-right intracardiac shunt

  • A. J. Edwards (a1), N. J. Ring (a1) and A. J. Marshall (a2)


We describe a 31-year-old man with Down's syndrome who presented with severe chronic hypothyroidism and a massive pericardial effusion. Following partial aspiration of this effusion, he rapidly deteriorated and died. Findings at autopsy revealed him to have an atrioventricular septal defect with shunting at the atrial level. We postulate that, by releasing extrinsic pressure on his right heart by the aspiration, there was sudden shunting of blood from left-to-right, resulting in hypotension, shock, and subsequent death. We highlight the difficulties in management of such a case, and suggest alternative strategies.


Corresponding author

Correspondence to: Dr A. J. Edwards, 2 West park villas, Whitchurch road, Horrabridge, S. Devon PL20 7TY. Tel: 01822 854385; E-mail:



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed