Pulmonary edema following pericardiotomy for cardiac tamponade.

A 57-year-old man with a history of a previous myocardial infarction presented with acute cardiac tamponade due to malignant pericardial effusion. Immediately following emergency surgical drainage of the pericardium by subxiphoid window, acute pulmonary edema developed. The sudden increase in venous return following the release of cardiac compression may result in this rare complication. Gradual removal of pericardial fluid under hemodynamic monitoring is advisable, particularly in patients with preexisting heart disease.