1/9. The postpericardiotomy syndrome as a cause of pleurisy in rehabilitation patients.Pleuritic chest pain in patients on a rehabilitation unit may be caused by several conditions. We report 2 cases of postpericardiotomy syndrome (PPS) as a cause of pleuritic pain. PPS occurs in 10% to 40% of patients who have coronary bypass or valve replacement surgery. The syndrome is characterized by fever, chest pain, and a pericardial or pleural friction rub. Its etiology is believed to be viral or immunologic. The syndrome can be a diagnostic challenge, and an increase in length of hospitalization because of it has been documented. Identified risk factors for PPS include age, use of prednisone, and a history of pericarditis. A higher incidence has been reported from May through July. Many patients undergo a battery of expensive procedures before PPS is diagnosed. The pain is sharp, associated with deep inspiration, and changes with position. Pleural effusions may be present and tend to occur bilaterally. Pericardial effusions are a documented complication. A pericardial or pleural rub may be present and is often transient. Serial auscultation is important. Laboratory work provides clues with a mild leukocytosis and an elevated erythrocyte sedimentation rate. However, this does not provide the definitive diagnosis. Cardiac enzymes are not reliably related to the syndrome. An electrocardiogram will show changes similar to those associated with pericarditis. The patient may have a fever, but it is rarely higher than 102.5 degrees F. Complications include pericardial effusions, arrhythmias, premature bypass graft closure, and cardiac tamponade. Treatment consists of a 10-day course of nonsteroidal anti-inflammatory drugs.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/9. Post cardiac injury syndrome--one more cause of false positive IgG, IgM antibodies in pleural fluid against antigen-60 of mycobacterium tuberculosis.Post cardiac injury syndrome (PCIS) is known to occur following myocardial infarction, cardiac surgery, blunt chest trauma, percutaneous left ventricular puncture and pace-maker implantation. The diagnosis is one of exclusion. We report a case of PCIS following cardiac surgery who showed false positive IgG, IgM antibodies to antigen A60 of mycobacterium tuberculosis in pleural fluid.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
3/9. Probable postcardiotomy syndrome following implantation of a transvenous pacemaker: report of the first case.The syndrome of fever and pericarditis is reported following implantation of a transvenous pacemaker in a 72-year-old man. The pacemaker was placed for prophylactic reasons (i.e., presence of bifascicular block). The syndrome resolved spontaneously after over four weeks of fever and a pericardial friction rub. Perforation of the right ventricle, although not recognized in this patient, is a complication which occurs with passage of a transvenous pacemaker. There was no other antecedent events to explain the syndrome such as myocardial infarction or trauma to the chest.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
4/9. postpericardiotomy syndrome after minimally invasive pectus excavatum repair unresponsive to nonsteroidal anti-inflammatory treatment.A 14-year-old boy developed postpericardiotomy syndrome after an otherwise uneventful minimally invasive pectus excavatum repair. Dyspnoea, chest pain, and pericardial effusion progressed despite nonsteroidal anti-inflammatory treatment. The symptoms rapidly resolved with intravenous methylprednisolone, and pericardiocentesis was thus avoided. This is the first report of postpericardiotomy syndrome after the Nuss procedure treated with systemic steroids.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
5/9. The postcardiac injury syndrome: case report and review of the literature.The postcardiac injury syndrome (PCIS) includes the postmyocardial infarction syndrome, the postcommissurotomy syndrome, and the postpericardiotomy syndrome. Dressler reported a series of patients who developed a pericarditis-like illness days to weeks after a myocardial infarction. Postcardiac injury syndrome also has been observed after cardiac surgery, percutaneous intervention, pacemaker implantation, and radiofrequency ablation. Postcardiac injury syndrome is characterized by pleuritic chest pain, low-grade fever, an abnormal chest x-ray, and the presence of exudative pericardial and/or pleural effusions. The pathophysiology of PCIS involves auto-antibodies that target antigens exposed after damage to cardiac tissue. The treatment of PCIS includes the use of nonsteroidal anti-inflammatory drugs and corticosteroids. Prophylactic use of corticosteroids before cardiac surgery has not been effective in preventing PCIS. The widespread use of reperfusion therapy and cardiac medications with anti-inflammatory properties may have reduced the incidence of PCIS. Although PCIS can follow a relapsing course, it does carry a favorable prognosis.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
6/9. The post-pericardiotomy syndrome and penetrating injury of the chest.The post-pericardiotomy syndrome is an uncommon complication of chest trauma. We present a case of recurrent pleural and pericardial effusions, pyrexia, pain in the chest and ECG changes of pericarditis in a young man with a penetrating chest injury.- - - - - - - - - - ranking = 3.5keywords = chest (Clic here for more details about this article) |
7/9. The postcardiac injury syndrome following percutaneous transluminal coronary angioplasty.A 57-year-old man, who had suffered an anterior Q-wave myocardial infarction complicated with typical post-cardiac injury syndrome (PCIS) 9 years earlier, underwent percutaneous transluminal coronary angioplasty (PTCA) without any immediate clinical, laboratory, or radiological signs of complications. After 4 days he recognized the recurrence of the earlier symptoms of PCIS. The diagnosis was supported by slight fever, elevated inflammatory parameters, and improvement when oral corticosteroids were given. The observations suggest that milder cardiac injury than previously considered, that is, without demonstrated structural damage to pericardium or myocardium, may precipitate PCIS in predisposed individuals. The case adds a differential diagnosis to chest pain and malaise following PTCA.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
8/9. postpericardiotomy syndrome and cardiac tamponade following transvenous pacemaker placement.This is the first reported case of cardiac tamponade presumed to be caused by postpericardiotomy syndrome (PPS) following endocardial pacemaker placement. An 84-year-old woman developed fever and dyspnea 3 weeks after pacemaker placement. physical examination revealed hypotension, tachycardia, and pulsus paradoxus. auscultation revealed clear lungs and diminished heart sounds. The sedimentation rate was 60 mm/h. echocardiography revealed a large pericardial effusion with signs of cardiac tamponade. Surgical drainage of the pericardial space resulted in complete resolution of symptoms. The pericardial fluid was culture- and cytologically negative. PPS is a common complication of cardiothoracic surgery and chest trauma. It rarely occurs after percutaneous procedures such as percutaneous transluminal coronary angioplasty and transvenous pacemaker placement. While usually having a benign, self-limited course, PPS can cause a serious complication as illustrated in this case report.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |
9/9. Reactive pleuropericarditis following laparoscopic fundoplication.postpericardiotomy syndrome is not uncommon following cardiac surgery. The syndrome is characterized by fever, chest pain, leucocytosis, and signs of pericardial and pleural effusions. A patient with similar symptoms after laparoscopic treatment of reflux esophagitis is reported. Antibiotic treatment had no effect on a suspected bacteriological infection. There was a dramatic clinical response to corticosteroid treatment. The etiology and pathogenesis of the syndrome are discussed.- - - - - - - - - - ranking = 0.5keywords = chest (Clic here for more details about this article) |