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The risk of fatal re-expansion pulmonary oedema in poor left ventricular reserve

Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield S5 7AU, UK

*Corresponding author. Tel.: +44 (0) 114 2434343; fax: +44 (0) 114 2610350.

E-mail address: edwkpeng{at}gmail.com (E.W.K. Peng).

Re-expansion pulmonary oedema (REPO) is an uncommon complication which may be encountered following drainage of pneumothorax, pleural effusion or haemopneumothorax. Treatment is usually supportive and some patients may require positive pressure ventilation. We provide a novel description of the mechanism of a fatal REPO in a patient with a small and non-compliant left ventricle (LV). We urge for an extreme caution when performing thoracocentesis in patients with poor LV reserve.

Key Words: Pleural effusion; Pulmonary oedema; Hypertrophic cardiomyopathy; Thoracocentesis