The Postpericardiotomy Syndrome

Abstract

Twenty-five patients known to have developed the postpericardiotomy syndrome were found to have had evidence of continuing pleural or pericardial inflammation at the time of ambulation or discharge from the hospital. These were compared with 25 unselected patients who had undergone pericardiotomy. Patients with an apparently benign course who developed a postpericardiotomy syndrome were contrasted with patients in whom a pleural or pericardial reaction persisted but in whom the full syndrome appeared to be averted by slow ambulation. In addition, six patients seen after the conclusion of the study are reported. On the basis of the features shown in the hospital course of the 25 who developed the postpericardiotomy syndrome it was considered that these six were candidates for this syndrome and all were treated conservatively. Three of the six developed a very mild syndrome of a transient nature that did not recur. It is concluded that the postpericardiotomy syndrome is not a condition occurring after a latent period but a process that is continuous from the time of operation or shortly thereafter; moreover the signs of this process may be detected. These signs are persistent pleural or pericardial friction rub, X-ray evidence of pleural or pericardial reaction, persistent fever, and occasionally electrocardiographic evidence of pericarditis. In almost every instance some or all of these findings can be detected prior to the onset of the full-blown syndrome.