Cardiac tamponade complicating trimodal therapy for malignant mesothelioma

Trimodal therapy, which includes extrapleural pneumonectomy as the cytoreductive procedure followed by combination chemoradiotherapy, is becoming the standard of care in the treatment of malignant mesothelioma. We report here a case of hypotension secondary to tension hydrothorax in which echocardiography and hemodynamic monitoring demonstrated evidence of tamponade physiology. Thoracentesis was lifesaving.