emDocs - June 17, 2019 - Author: Montrief T - Edited by: Koyfman A and Long B
"Pearls and Pitfalls
- Post-CABG patients most commonly present to the ED for post-operative infections, CHF, and chest discomfort.
- DSWIs occur in 1–2% of all patients undergoing cardiac surgery, but have up to a 30% mortality rate.
- Ultrasound is an invaluable tool to evaluate for a pericardial effusion, but a retrocardiac clot is difficult to see on either transthoracic echo or X-ray and may be missed.
- Acute resuscitation of the hemodynamically unstable post-CABG patient includes optimizing preload, rate, rhythm, contractility, and afterload.
- Early surgical consultation can help guide the diagnostic and therapeutic management."