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Asymptomatic Postoperative Pericardial Effusions: Against the Routine Use of Anti-inflammatory Drug Therapy

Massimo Imazio, MD
[+] Article, Author, and Disclosure Information

From Maria Vittoria Hospital, 10141 Turin, Italy.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M09-2758.

Requests for Single Reprints: Massimo Imazio, MD, Cardiology Department, Maria Vittoria Hospital, Via Cibrario 72, 10141 Turin, Italy; e-mail, massimo_imazio@yahoo.it.

Ann Intern Med. 2010;152(3):186-187. doi:10.7326/0003-4819-152-3-201002020-00012
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The management of postoperative pericardial effusion is a common problem in clinical practice—50% to 85% of patients develop effusion after cardiac surgery (13). Cardiac tamponade, the most feared complication, occurs in approximately 2% of patients and is observed even among those who have a subacute course and are beyond 7 days after surgery (3). The pathogenesis of postoperative effusions is not completely understood. Early effusions (within 5 to 7 days of surgery) are probably related to pericardial bleeding and perioperative trauma, whereas late effusions are considered the possible consequence of pericarditis. These late effusions often characterize the so-called “postpericardiotomy syndrome” reported after 10% to 45% of heart surgery cases (4).

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