Pericardial effusion refers to the accumulation of fluid within the pericardial space between the
visceral and parietal pericardium. While small amounts of fluid (15–50 ml) are normal, larger
collections can impair cardiac filling and potentially lead to cardiac tamponade, a lifethreatening condition.
Management depends on the severity of symptoms, hemodynamic status, and underlying cause.
In many cases, pericardiocentesis is the first-line intervention. However, anatomical
abnormalities may complicate the procedure and necessitate surgical pericardiostomy.
This case illustrates the challenges encountered during pericardial drainage in a patient with
chest wall deformity and suspected congenital syndrome, requiring conversion from bedside
pericardiocentesis to open surgical drainage.