International journal of cardiology
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Our observations and experience suggest that an adverse outcome from perioperative infarction occurs predominantly in a defined population of patients. A worsened prognosis and special postoperative interventions need not be anticipated in patients who have simply developed new Q waves after bypass surgery and are free of malignant ventricular arrhythmias and severe degrees of myocardial dysfunction. Furthermore, our data indicates that repeat throacotomy because of bleeding or tamponade early after sustaining a perioperative infarction will adversely affect the outcome of that infarction.
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We followed 34 consecutive patients with the postpericardiotomy syndrome for a median of 7 years. In each patient, the syndrome was documented by the occurrence of: (1) a pericardial type of pain or pericardial rub (or both); and (2) fever or an elevated erythrocyte sedimentation rate. The postpericardiotomy syndrome occurred at a median postoperative time of 4 weeks (range, 2 to 52 weeks). ⋯ Of the 9 patients receiving anticoagulants alone and in whom this treatment was continued, none had clinical evidence of hemopericardium. On follow-up, 7 patients (21%) had an initial recurrence at an interval of 1 to 3 months; 5 of these patients had further recurrences at an interval of 3 to 30 months. This long-term study indicates that the postperiocardiotomy syndrome is a benign but often recurrent clinical entity, presumably related to viral and/or immunologic factors.