[Postcardiac injury syndrome]

Abstract

The post-pericardiotomy syndrome is a symptom complex which is similar in many respects to the post-myocardial infarction syndrome and these are summarized under the diagnosis of the Post Cardiac Injury Syndrome (PCIS). This condition, which is observed most frequently after open heart surgery, is characterized by pyrexia, pericarditis and increased inflammation parametres. These symptoms develop 2-12 weeks after the trauma. The etiology is unknown but autoimmunity probably plays a part, possibly precipitated by virus infection. PCIS is a diagnosis by exclusion. No definite test is available to identify patients with or without PCIS but demonstration of antimyocardial antibodies may be valuable in the differential diagnostic deliberations. As a rule, the course of the condition is benign and self-limiting but there is a tendency to recurrence. In rare cases, the inflammatory process may encroach on the coronary vessels, with cardiac tamponade and chronic pericardial exudate. In the lighter cases, PCIS may be treated with NSAID and, in the more severe cases, with systemic glucocorticoid which has a prompt effect.