Pericardial Effusion-Associated Hyponatremia

Abstract

Pericardial effusion has been identified as a rare cause of hyponatremia. In most patients, pericardiocentesis results in rapid correction. We describe a 67-year-old male who presented with pericardial effusion-associated hyponatremia secondary to cardiac resynchronization therapy-D placement that resolved following evacuation. In addition, we review the literature on pericardial effusion-associated hyponatremia.

Figure 1

A two-view chest X-ray demonstrating enlarged cardiac silhouette, minimal bibasilar atelectasis, and appropriate placement of pacemaker leads (a, b).

Figure 2

(a) Large circumferential pericardial effusion measuring 2.6 centimeters posteriorly, 1.5 centimeters anteriorly, and 1.8 centimeters at the apex with right atrial collapse and without right ventricular collapse. Significant inflow variation was noted across the mitral and tricuspid valves. Left ventricular ejection fraction was estimated at 55%. Mild concentric left ventricular hypertrophy was present. (b) Echocardiogram obtained the day after pericardial drainage demonstrates resolution of the pericardial effusion.

Figure 3

Serum sodium level during the hospital stay. Rapid correction of hyponatremia was observed within 36 hours of pericardiocentesis.