title: Postpericardiotomy syndrome and cardiac tamponade following transvenous pacemaker placement.
abstract: This 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.
authors.affiliation: Department of Medicine, Brown University School of Medicine, VAMC, Providence, Rhode Island 02908, USA.
authors.forename: G L
authors.initials: GL
authors.lastname: Miller
authors.forename: E B
authors.initials: EB
authors.lastname: Coccio
authors.forename: S C
authors.initials: SC
authors.lastname: Sharma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002305:Cardiac Tamponade / Q000209:etiology*; D005260:Female; D006327:Heart Block / Q000628:therapy; D006347:Heart Sounds; D006801:Humans; D007022:Hypotension / Q000209:etiology; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010490:Pericardial Effusion / Q000209:etiology; D011185:Postpericardiotomy Syndrome / Q000209:etiology*; D011674:Pulse; D013610:Tachycardia / Q000209:etiology