The disappearing pericardial effusion: a pericardial-pleural fistula.

We report a case of rapid resolution of a pericardial effusion and development of a pleural effusion after pericardiocentesis in an 83-year-old man admitted for increasing dyspnea. We hypothesize that during the procedure, a pericardial-pleural fistula was created during either the insertion of the needle or the guide wire advancement. This case highlights an unusual complication of pericardiocentesis and the importance of two-dimensional echocardiography surveillance.