Postpericardiotomy syndrome
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| 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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Synonyms and Related Keywords: Postcommissurotomy syndrome
The postpericardiotomy syndrome is a frequent complication after cardiac surgery affecting from 20 to 40% of patients. 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.
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. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10]
Incidence of postpericardiotomy syndrome is 10 to 50% in open heart surgery patients in US. [11] [12]
Symptoms and Signs
Symptoms usually become manifest several weeks after a major cardiac operation.
- Anorexia
- Buildup of fluid around heart
- Buildup of fluid around lungs
- Chest pain
- Enlarged heart
- Fever
- Increased erythrocyte sedimentation rate
- Irritability
- Joint pain
- Leukocytosis
- Malaise
- Muscle pain
- Palpitation
- Pericardial friction rub
- Shortness of breath
- Tachycardia
Diagnosis
Differential Diagnosis
Complications
Treatment
- Bed rest
- NSAIDs
References
- ↑ Gungor B, Ucer E, Erdinler IC. Uncommon presentation of postcardiac injury syndrome: Acute pericarditis after percutaneous coronary intervention. Int J Cardiol. Aug 14 2007
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Hargreaves M, Bashir Y. Postcardiotomy syndrome following transvenous pacemaker insertion. Eur Heart J. Jul 1994;15(7):1005-7.
- ↑ 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.
- ↑ Tabatznik B, Isaacs JP. Postpericardiotomy syndrome following traumatic hemopericardium. Am J Cardiol. Jan 1961;7:83-96.
- ↑ 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.
- ↑ McClendon CE, Leff RD, Clark EB. Postpericardiotomy syndrome. Drug Intell Clin Pharm 1986;20:20-3.
- ↑ Kaminsky ME, Rodan BA, Osborne DR, Chen JT, Sealy WC, Putman CE. Postpericardiotomy syndrome. AJR 1982;138:503-8.