Which of the following is a common complication after cardiac surgery?

Which of the following is a common complication after cardiac surgery?

• A. Atrial fibrillation
• B. Dressler's syndrome
• C. Pneumonia
• D. Infection

Answer: (A)

Postoperative atrial fibrillation is the most common complication after cardiac surgery. The heart’s atria are irritated during surgery, and inflammatory and autonomic changes are heightened in the immediate recovery period. Factors such as atrial stretch from fluid shifts, electrolyte disturbances, myocardial stunning from bypass, and increased adrenergic tone create a substrate for chaotic atrial activity and reentry circuits, making AF likely to develop within the first 24 to 72 hours after surgery. Clinically this can cause a rapid ventricular rate, reducing cardiac output when the heart is already stressed, and it raises concerns for thromboembolism if it persists. Dressler’s syndrome, a postpericardiotomy syndrome, tends to occur later—weeks after surgery—with chest pain, fever, and pericardial effusion, so it’s less likely to be the immediate, common complication. Pneumonia and general infection are risks in the postoperative period, especially with intubation and hospitalization, but they do not occur as characteristically or as frequently in the immediate post-op phase as atrial fibrillation. Managing AF promptly with rate control and, when appropriate, rhythm control helps maintain hemodynamic stability in this setting.

Postoperative atrial fibrillation is the most common complication after cardiac surgery. The heart’s atria are irritated during surgery, and inflammatory and autonomic changes are heightened in the immediate recovery period. Factors such as atrial stretch from fluid shifts, electrolyte disturbances, myocardial stunning from bypass, and increased adrenergic tone create a substrate for chaotic atrial activity and reentry circuits, making AF likely to develop within the first 24 to 72 hours after surgery. Clinically this can cause a rapid ventricular rate, reducing cardiac output when the heart is already stressed, and it raises concerns for thromboembolism if it persists.

Dressler’s syndrome, a postpericardiotomy syndrome, tends to occur later—weeks after surgery—with chest pain, fever, and pericardial effusion, so it’s less likely to be the immediate, common complication. Pneumonia and general infection are risks in the postoperative period, especially with intubation and hospitalization, but they do not occur as characteristically or as frequently in the immediate post-op phase as atrial fibrillation. Managing AF promptly with rate control and, when appropriate, rhythm control helps maintain hemodynamic stability in this setting.