Postpericardiotomy and Postmyocardial Infarction Syndrome (5)

Postpericardiotomy and Postmyocardial Infarction Syndrome (5)Summary
A patient who had a previous myocardial infarction, coronary artery bypass surgery, and angioplasty (with preserved left ventricular function) had an acute inferior MI requiring a temporary pacemaker. He became progressively hypoxemic and developed pulmonary edema. At this time, his echocardiogram revealed an ejection fraction of 60 percent and there was no mitral regurgitation, ventricular septal defect, or pericardial effusion. The sedimentation rate rose to 108 mm/h. There was continued hypoxic deterioration despite oxygen, IV nitroglycerine, diuretics, and captopril. Dramatic improvement and recovery followed methylprednisolone therapy. antibiotics levaquin
Case 2
A 57-year-old woman who had undergone coronary bypass surgery in 1978 developed unstable angina and was admitted to Presbyterian Hospital for a second operation. Four days prior to surgery, she underwent cardiac catheterization that revealed normal left ventricular function with an ejection fraction of 85 percent. Angiography disclosed severe two-vessel native coronary artery disease with an occluded saphenous vein graft to the right coronary artery, an occluded vein graft to the first diagonal and left anterior descending coronary arteries, and a patent left internal mammary artery graft. She underwent a second bypass operation on February 26, 1990.

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