What Is a Bilateral Myringotomy?

The syndrome after pericardiotomy refers to clinical symptoms such as fever, pericarditis, and pleurisy after 1 to 3 weeks of cardiac surgery. The incidence of syndrome after pericardiotomy is 10% to 40%, and the incidence is higher in children than in adults. Recurrence occurs in 5% of patients within the first 3 months after surgery. This syndrome first occurs in patients with mitral valve surgery for rheumatic heart disease, which is thought to be a recurrence of rheumatic fever. Later, this syndrome also occurs in patients with non-rheumatic heart disease after cardiac surgery. The clinical manifestations of the pericardial incision syndrome can also occur when an embedded cardiac pacemaker pacing catheter causes cardiac perforation, blunt chest contusion, epicardial implantation of a pacemaker, and coronary perforation caused by coronary angioplasty. feature.

Basic Information

English name: postpericardiotomy syndrome
Visiting department: Internal medicine

Multiple groups: child
Common causes: Complications of cardiac surgery and other cardiac interventions
Common symptoms: Fever, fatigue, chest pain, etc.

Causes of syndrome after pericardiotomy

Complications after cardiac surgery and other cardiac interventions.

Clinical manifestations of syndrome after pericardiotomy

Acute onset usually occurs 2 to 3 weeks after heart surgery and is characterized by fever, fatigue, and chest pain. In some cases, fever persisted within 1 week after surgery. Chest pain is a feature of acute pericarditis. The nature of chest pain is similar to pleurisy. Other non-specific manifestations of inflammation include accelerated erythrocyte sedimentation rate (erythrocyte sedimentation) and elevated neutrophils. Atypical cases can only have fever, ECG changes, and accelerated red blood cell sedimentation rate, without sternal pain and pericardial friction sounds. This syndrome can recur, with recurrence occurring in the first 3 months after surgery in 5% of patients.

Syndrome examination after pericardiotomy

Laboratory inspection

(1) The white blood cell count increased, mostly at (10-15) × 10 ⁹ / L, and the neutrophil increased.

(2) The blood cell sedimentation rate is increased.

(3) C-reactive protein is elevated.

(4) Immunofluorescence technology can find anti-cardiac antibodies in the blood of patients.

2. Other auxiliary inspections

(1) X-ray examination showed a moderately enlarged heart with pericardial effusion. Pleural effusion in the left or bilateral of 1/3 patients, and pulmonary infiltration in 1/10 patients.

(2) Echocardiogram showed pericardial effusion.

(3) ECG can show non-specific ST-T changes and paroxysmal atrial tachycardia.

Diagnosis of syndrome after pericardiotomy

The diagnosis of the syndrome after pericardiotomy is an exclusionary rule, and other causes of fever, discomfort, and chest pain should be fully considered and excluded before diagnosis.

Differential diagnosis of syndrome after pericardiotomy

The disease needs to be distinguished from other causes after the operation, including fever due to infection.

Syndrome complications after pericardiotomy

Recurrent pericardial tamponade may occur, but constrictive pericarditis is rare.

Treatment of syndrome after pericardiotomy

Fever and chest pain can be alleviated with aspirin or non-hormonal anti-inflammatory drugs. Hormonal treatment can be used if it is not effective within 48 hours after administration. Cardiac tamponade is performed with pericardial puncture. Repeated tamponade requires pericardial resection. Constrictive pericarditis is rare and occurs in the months to years after the pericardiectomy syndrome.