Postpericardiotomy syndrome: Difference between revisions

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'''''Synonyms and Related Keywords:''''' Postcommissurotomy syndrome
 
'''Synonyms and Related Keywords:''' Postcommissurotomy syndrome


==Overview==
==Overview==
The '''postpericardiotomy syndrome''' is inflammation of the [[pericardium]] (the sac surrounding the heart) following [[cardiac surgery]]. Symptoms can occur from days to weeks after the operation.  [[Colchicine]] is safe and effective in the treatment and prevention of pericarditis and preliminary data have shown that it may be effective also in the primary prevention of the postpericardiotomy syndrome.


The '''postpericardiotomy syndrome''' is a frequent complication after cardiac surgery. Symptoms can occur from days to weeks after the operation. The etiology of this complication is a subject of debate. It is commonly believed to be an autoimmune response to pericardial and/or pleural bleeding or surgical trauma. Colchicine is safe and effective in the treatment and prevention of pericarditis and preliminary data have shown that it may be effective also in the primary prevention of the postpericardiotomy syndrome.
==Epidemiology and Demographics==


It has also been described following [[myocardial infarction]] ([[Dressler's syndrome]]), and as an unusual complication after [[percutaneous coronary intervention]] such as stent implantation or after implantation of epicardial pacemaker leads and transvenous pacemaker leads, following blunt trauma, stab wounds, and heart puncture. <ref>Gungor B, Ucer E, Erdinler IC. Uncommon presentation of postcardiac injury syndrome: Acute pericarditis after percutaneous coronary intervention. ''Int J Cardiol''. Aug 14 2007</ref> <ref>Peters RW, Scheinman MM, Raskin S, Thomas AN. Unusual complications of epicardial pacemakers. Recurrent pericarditis, cardiac tamponade and pericardial constriction. ''Am J Cardiol''. May 1980;45(5):1088-94.</ref> <ref>Vinit J, Sagnol P, Buttard P, Laurent G, Wolf JE, Dellinger A. Recurrent delayed pericarditis after pacemaker implantation: a post-pericardiotomy-like syndrome?. ''Rev Med Interne''. Feb 2007;28(2):137-40.</ref> <ref>Zeltser I, Rhodes LA, Tanel RE, Vetter VL, Gaynor JW, Spray TL. Postpericardiotomy syndrome after permanent pacemaker implantation in children and young adults. ''Ann Thorac Surg''. Nov 2004;78(5):1684-7.</ref> <ref>Sasaki A, Kobayashi H, Okubo T, Namatame Y, Yamashina A. Repeated postpericardiotomy syndrome following a temporary transvenous pacemaker insertion, a permanent transvenous pacemaker insertion and surgical pericardiotomy. ''Jpn Circ J''. Apr 2001;65(4):343-4.</ref> <ref>Goutal H, Baur F, Bonnevie L, Monnier G, Le Blainvaux M, Brion R. Postpericardiotomy syndrome; a rare complication of transcavitary cardiac pacing: apropos of a case. ''Arch Mal Coeur Vaiss''. Dec 1995;88(12):1901-3.</ref> <ref>Hargreaves M, Bashir Y. Postcardiotomy syndrome following transvenous pacemaker insertion. ''Eur Heart J''. Jul 1994;15(7):1005-7.</ref> <ref>Goodkind MJ, Bloomer WE, Goodyer AV. Recurrent pericardial effusion after nonpenetrating chest trauma: report of two cases treated with adrenocortical steroids. ''N Engl J Med''. Nov 3 1960;263:874-81.</ref> <ref>Tabatznik B, Isaacs JP. Postpericardiotomy syndrome following traumatic hemopericardium. ''Am J Cardiol''. Jan 1961;7:83-96.</ref> <ref>Peter RH, Whalen RE, Orgain ES, McIntosh HD. Postpericardiotomy syndrome as a complication of percutaneous left ventricular puncture. ''Am J Cardiol''. Jan 1966;17(1):86-90.</ref>
==Pathophysiology==
It has been postulated that the syndrome is an [[autoimmune]] response to pericardial and/or pleural bleeding or surgical trauma.  


Incidence of postpericardiotomy syndrome is 10 to 50% in open heart surgery patients in US <ref>McClendon CE, Leff RD, Clark EB. Postpericardiotomy syndrome. Drug Intell Clin Pharm 1986;20:20-3.</ref> <ref>Kaminsky ME, Rodan BA, Osborne DR, Chen JT, Sealy WC, Putman CE. Postpericardiotomy syndrome. AJR 1982;138:503-8.</ref>
==Conditions that Postpericardiotomy Syndrome should be Distinguished From==
Postpericardiotomy syndrome should be distinguished from [[Dressler's syndrome]] which is an autoimmune process that occurs weeks following ST elevation MI.


==Symptoms and Signs==
==Causes==
*Pericardial and/or pleural bleeding
*Surgical trauma
*Postpericardiotomy syndrome can be an unusual complication after [[percutaneous coronary intervention]] such as stent implantation or after implantation of epicardial pacemaker leads and transvenous pacemaker leads, following blunt trauma, stab wounds, and heart puncture. <ref>Gungor B, Ucer E, Erdinler IC. Uncommon presentation of postcardiac injury syndrome: Acute pericarditis after percutaneous coronary intervention. ''Int J Cardiol''. Aug 14 2007</ref> <ref>Peters RW, Scheinman MM, Raskin S, Thomas AN. Unusual complications of epicardial pacemakers. Recurrent pericarditis, cardiac tamponade and pericardial constriction. ''Am J Cardiol''. May 1980;45(5):1088-94.</ref> <ref>Vinit J, Sagnol P, Buttard P, Laurent G, Wolf JE, Dellinger A. Recurrent delayed pericarditis after pacemaker implantation: a post-pericardiotomy-like syndrome?. ''Rev Med Interne''. Feb 2007;28(2):137-40.</ref> <ref>Zeltser I, Rhodes LA, Tanel RE, Vetter VL, Gaynor JW, Spray TL. Postpericardiotomy syndrome after permanent pacemaker implantation in children and young adults. ''Ann Thorac Surg''. Nov 2004;78(5):1684-7.</ref> <ref>Sasaki A, Kobayashi H, Okubo T, Namatame Y, Yamashina A. Repeated postpericardiotomy syndrome following a temporary transvenous pacemaker insertion, a permanent transvenous pacemaker insertion and surgical pericardiotomy. ''Jpn Circ J''. Apr 2001;65(4):343-4.</ref> <ref>Goutal H, Baur F, Bonnevie L, Monnier G, Le Blainvaux M, Brion R. Postpericardiotomy syndrome; a rare complication of transcavitary cardiac pacing: apropos of a case. ''Arch Mal Coeur Vaiss''. Dec 1995;88(12):1901-3.</ref> <ref>Hargreaves M, Bashir Y. Postcardiotomy syndrome following transvenous pacemaker insertion. ''Eur Heart J''. Jul 1994;15(7):1005-7.</ref> <ref>Goodkind MJ, Bloomer WE, Goodyer AV. Recurrent pericardial effusion after nonpenetrating chest trauma: report of two cases treated with adrenocortical steroids. ''N Engl J Med''. Nov 3 1960;263:874-81.</ref> <ref>Tabatznik B, Isaacs JP. Postpericardiotomy syndrome following traumatic hemopericardium. ''Am J Cardiol''. Jan 1961;7:83-96.</ref> <ref>Peter RH, Whalen RE, Orgain ES, McIntosh HD. Postpericardiotomy syndrome as a complication of percutaneous left ventricular puncture. ''Am J Cardiol''. Jan 1966;17(1):86-90.</ref>
 
==Diagnosis==
===Symptoms and Signs===


Symptoms usually become manifest several weeks after a major cardiac operation.
Symptoms usually become manifest several weeks after a major cardiac operation.
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* [[Tachycardia]]
* [[Tachycardia]]


==Diagnosis==
==Laboratory Studies==


* [[CBC]]
* [[CBC]]
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{{Circulatory system pathology}}
{{Circulatory system pathology}}
{{Electrocardiography}}
{{SIB}}
{{SIB}}


[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Surgery]]
[[Category:Surgery]]
 
[[CAtegory:Mature chapter]]


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Revision as of 15:40, 26 July 2011

Postpericardiotomy syndrome
Fibrinous pericarditis: Gross, natural color, excellent external view of typical fibrinous pericarditis (After mitral valve replacement).
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and Related Keywords: Postcommissurotomy syndrome

Overview

The postpericardiotomy syndrome is inflammation of the pericardium (the sac surrounding the heart) following cardiac surgery. Symptoms can occur from days to weeks after the operation. Colchicine is safe and effective in the treatment and prevention of pericarditis and preliminary data have shown that it may be effective also in the primary prevention of the postpericardiotomy syndrome.

Epidemiology and Demographics

Pathophysiology

It has been postulated that the syndrome is an autoimmune response to pericardial and/or pleural bleeding or surgical trauma.

Conditions that Postpericardiotomy Syndrome should be Distinguished From

Postpericardiotomy syndrome should be distinguished from Dressler's syndrome which is an autoimmune process that occurs weeks following ST elevation MI.

Causes

  • Pericardial and/or pleural bleeding
  • Surgical trauma
  • Postpericardiotomy syndrome can be an unusual complication after percutaneous coronary intervention such as stent implantation or after implantation of epicardial pacemaker leads and transvenous pacemaker leads, following blunt trauma, stab wounds, and heart puncture. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10]

Diagnosis

Symptoms and Signs

Symptoms usually become manifest several weeks after a major cardiac operation.

Laboratory Studies

Differential Diagnosis

Complications

Treatment

References

  1. Gungor B, Ucer E, Erdinler IC. Uncommon presentation of postcardiac injury syndrome: Acute pericarditis after percutaneous coronary intervention. Int J Cardiol. Aug 14 2007
  2. Peters RW, Scheinman MM, Raskin S, Thomas AN. Unusual complications of epicardial pacemakers. Recurrent pericarditis, cardiac tamponade and pericardial constriction. Am J Cardiol. May 1980;45(5):1088-94.
  3. Vinit J, Sagnol P, Buttard P, Laurent G, Wolf JE, Dellinger A. Recurrent delayed pericarditis after pacemaker implantation: a post-pericardiotomy-like syndrome?. Rev Med Interne. Feb 2007;28(2):137-40.
  4. Zeltser I, Rhodes LA, Tanel RE, Vetter VL, Gaynor JW, Spray TL. Postpericardiotomy syndrome after permanent pacemaker implantation in children and young adults. Ann Thorac Surg. Nov 2004;78(5):1684-7.
  5. Sasaki A, Kobayashi H, Okubo T, Namatame Y, Yamashina A. Repeated postpericardiotomy syndrome following a temporary transvenous pacemaker insertion, a permanent transvenous pacemaker insertion and surgical pericardiotomy. Jpn Circ J. Apr 2001;65(4):343-4.
  6. Goutal H, Baur F, Bonnevie L, Monnier G, Le Blainvaux M, Brion R. Postpericardiotomy syndrome; a rare complication of transcavitary cardiac pacing: apropos of a case. Arch Mal Coeur Vaiss. Dec 1995;88(12):1901-3.
  7. Hargreaves M, Bashir Y. Postcardiotomy syndrome following transvenous pacemaker insertion. Eur Heart J. Jul 1994;15(7):1005-7.
  8. Goodkind MJ, Bloomer WE, Goodyer AV. Recurrent pericardial effusion after nonpenetrating chest trauma: report of two cases treated with adrenocortical steroids. N Engl J Med. Nov 3 1960;263:874-81.
  9. Tabatznik B, Isaacs JP. Postpericardiotomy syndrome following traumatic hemopericardium. Am J Cardiol. Jan 1961;7:83-96.
  10. Peter RH, Whalen RE, Orgain ES, McIntosh HD. Postpericardiotomy syndrome as a complication of percutaneous left ventricular puncture. Am J Cardiol. Jan 1966;17(1):86-90.

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