Postcardiac injury rheumatism.

The incidence, clinical comparison, laboratory features, therapeutic choices with outcomes of early and late postcardiac injury rheumatism (PIR) were studied prospectively. Out of the 249 patients who survived cardiac surgery, 20 (8%) and 22 (9%) patients had early and late PIR respectively. Earlier onset (within two weeks of surgery), milder articular involvement, absence of constitutional features and laboratory abnormalities and good response to analgesics were characteristics of early PIR. In contrast, late PIR which occurred between the third and fourteenth week after surgery was associated with more marked articular involvement along with systemic and laboratory abnormalities and required longer analgesic therapy, steroid support or prolonged physiotherapy in different combinations. We conclude that two distinct rheumatic syndromes with different clinical dimensions and therapeutic options can occur after cardiac surgery.