Q How is a pericardial effusion detected following coronary artery bypass surgery?

A Dave Hanson, RN, MSN, CCRN, CNS, replies:

Despite advances with percutaneous catheter interventions, cardiac surgical procedures continue to be widely used as a definitive therapy for patients with significant coronary and valvular disease. Coronary artery bypass graft surgery is a well established treatment for myocardial revascularization and more than 300000 patients undergo this surgical procedure annually in the United States.11 Pericardial effusion can occur after open heart surgery and contributes to postoperative morbidity and mortality.22 

The diagnosis of pericardial effusion is made by the presence of an abnormal amount and/or character of fluid in the pericardial space. The pericardial space normally contains 15 to 50 mL of fluid, which serves as lubrication for the visceral and parietal layers of the pericardium. This...

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