POSTPERICARDIOTOMY-SYNDROME

Fever after a cardiac operation is commonly caused by myocardial infar ction, postpericardiotomy syn drome, post-myocardial infarction syndro me (Dressier's syndrome), or postperfusion syndrome resulting from cyt omegalovirus infection. Postpericardiotomy syndrome and post-myocardia l infarction syndrome are autoimmune disorders characterized by eosino philia, pleuritic chest pain, and pleural effusions. In contrast, the diagnosis of postperfusion syndrome caused by cytomegalovirus is sugge sted if the patient has a mild sore throat, no pleural component or ch est pain, no eosinophilia, and atypical lymphocytosis. The syndromes o f injury after cardiac surgical procedures are diagnoses of exclusion, but the diagnosis of postperfusion syndrome (''40-day postoperative f ever'') may be made on the basis of elevated cytomegalovirus IgM titer s.