• Clinical cardiology · Mar 1996

    Case Reports

    Postpericardiotomy syndrome and cardiac tamponade following transvenous pacemaker placement.

    • G L Miller, E B Coccio, and S C Sharma.
    • Department of Medicine, Brown University School of Medicine, VAMC, Providence, Rhode Island 02908, USA.
    • Clin Cardiol. 1996 Mar 1; 19 (3): 255-6.

    AbstractThis 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.

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