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The Phrenic Nerves, Diaphragm and Pericardium.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
This may be due to various non-malignant causes; viral or bacterial infection, post-myocardial infarction (Dressler's syndrome), uraemia, myxoedema, trauma, aneurysm of the heart or intra-pericardial parts of the great vessels (such as the aortic root), post-irradiation or postpericardiotomy syndrome, trauma, etc. Pericardial tuberculosis used to be not uncommon in hospital practice in the UK, but is now rarely seen (but did not stop a case occurring with organisms resistant to therapy in 1992 in a patient from Africa).
Deaths Following Cardiac Surgery and Invasive Interventions
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Post-operative pericardial effusion is a common finding after cardiac surgery. Most effusions are small, asymptomatic and inconsequential, with reported rates up to 84% of patients in prospective studies and significantly less in retrospective studies. The effusion tends to reach its maximum size by the tenth post-operative day after which it typically resolves spontaneously. Effusions can persist or progress and ultimately proceed to cause life-threatening cardiac tamponade. Persisting effusion has been found in approximately one-fifth of cardiac surgery patients at post-operative day 20, and the incidence of late cardiac tamponade is estimated to be between 1% and 2.6%. Early post-operative cardiac tamponade is caused by surgical and/or microvascular bleeding. Late tamponade is connected to postpericardiotomy syndrome, an inflammatory reaction of the pericardium brought on by the surgical procedure. Cardiac tamponade necessitates invasive treatment, most commonly pericardiocentesis, percutaneous drainage or surgical fenestration.
Cardiovascular Disease
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Additional complications include pericarditis after CABG, which is due to pericardial injury and known as a postpericardiotomy syndrome. The most frequent complaint is chest pain, occurring a few days to several weeks after surgery. In most cases, the effusion is small and clinically insignificant; however, the pericardial effusion may be large, resulting in tamponade and hemodynamic instability requiring urgent therapy with pericardiocentesis or reoperation. Postoperative anticoagulation may increase the risk of tamponade in patients who develop an effusion.81–83 Neurological complications include brachial plexus injury, stroke, intracranial hemorrhage, encephalopathy, delirium, and seizures.84–87 Patients with postcoronary artery bypass grafting should be closely monitored for complications and have a cardiac rehabilitation program individualized to address their complications in a cardiac rehabilitation program.
Primary prevention of post-pericardiotomy syndrome using corticosteroids: a systematic review
Published in Expert Review of Cardiovascular Therapy, 2018
Rachel Wamboldt, Gianluigi Bisleri, Benedict Glover, Sohaib Haseeb, Gary Tse, Tong Liu, Adrian Baranchuk
Postpericardiotomy syndrome (PPS) is a significant immune-mediated inflammatory phenomenon which complicates the post-operative clinical course in 10–40% of patients who undergo cardiac surgery [1–3]. PPS was initially described in 1952 by Janton et al. as a syndrome with fever and pleuritic chest pain that followed surgery for rheumatic mitral stenosis [4]. PPS can occur days to months after cardiac surgery, usually after a patient has been discharged from hospital. PPS is an immune-mediated inflammatory process that usually manifests as a simple pericarditis or pleural effusion; however, potentially life-threatening complications including constrictive pericarditis or cardiac tamponade have been well documented in case studies [1,5–9].
Postpericardiotomy syndrome after cardiac surgery
Published in Annals of Medicine, 2020
Joonas Lehto, Tuomas Kiviniemi
Postpericardiotomy syndrome (PPS) is a common complication after cardiac surgery. The syndrome is a subgroup of post-cardiac injury syndromes (PCIS) together with postmyocardial infarction syndrome (Dressler’s syndrome) and posttraumatic pericarditis [1]. The typical clinical picture consists of pleuritic chest pain and fever appearing few days to several weeks after cardiac surgery [2]. Although the syndrome was first described in the 1950s [3,4], the aetiology of the syndrome has remained obscure. Currently, PPS is presumed to be an immune-mediated process initiated by pericardial and/or pleural damage and pericardial bleeding but the role other possible acquired factors is not well understood [2].
Advances in medical therapy for pericardial diseases
Published in Expert Review of Cardiovascular Therapy, 2018
Alessandro Galluzzo, Massimo Imazio
While the incidence of postpericardiotomy syndrome was reduced in the colchicine group, no difference was found for the outcome of postoperative AF or postoperative pericardial/pleural effusion after a 3-months follow up.