Delayed cardiac tamponade associated with prophylactic anticoagulation in patients undergoing coronary bypass grafting. Early diagnosis with two-dimensional echocardiography

Pericardial tamponade occurring late in the hospitalization of a patient who has undergone a heart operation can be life threatening. Recognition of this insidious, but treatable, complication is difficult. Three patients experienced delayed tamponade while receiving warfarin prophylactically following coronary arter bypass. Two-dimensional echocardiography was useful in recognizing the effusion (and thus aided the diagnosis of tamponade) in each patients. The question of whether prophylactic antiocagulatin should be employed for patients undergoing coronary artery bypass procedures is also considered in light of both the present experience and collected reports from the literature.