What is postpericardiotomy syndrome?

• A. A postoperative arrhythmia
• B. A type of heart failure after CABG
• C. An inflammatory reaction involving the pleura & pericardium; cause thought to be autoimmune & may be associated w/ blood remaining in the pericardial sac
• D. A bacterial infection of the mediastinal tissue

Answer: (C)

Postpericardiotomy syndrome is an inflammatory reaction that occurs after surgical opening or manipulation of the heart, affecting both the pericardium and the adjacent pleura. The condition is thought to be autoimmune in origin, triggered by exposure of cardiac antigens during surgery, and it can be worsened if blood remains in the pericardial sac. Clinically, it presents with chest pain, fever, a pericardial friction rub, and often pleural effusions or pericardial effusion weeks after surgery. It is not a rhythm disturbance, not a form of heart failure from poor pumping, and not a bacterial infection. Treatment focuses on anti-inflammatory therapy, such as NSAIDs and sometimes colchicine, with careful monitoring of effusions.