Postpericardiotomy syndrome (PPS) is a disorder which occurs after cardiac surgery. Most patients present with a fever, pleurisy, pleural effusions, hypoxia, and may have pulmonary infiltrates. Those patients begin to develop symptoms within two days to four weeks after cardiac surgery. PPS occurs in approximately 18% of all patients who have undergone coronary artery bypass grafting (CABG).
We have found that a therapeutic and diagnostic thoracentesis greatly improves patients’ symptoms and sense of well-being. The pleural fluid is usually a bloody exudate.
PPS is responsive to nonsteroidal antiinflammatory drugs (NSAIDs). Indomethacin is used most commonly. We will often place patients on prednisone who are intolerant to NSAIDs.