PCIS occurs after a variety of injuries to the myocardium and pericardium.6Most often, the entity is described as a result of myocardial infarction, trauma, or open-heart surgery. After cardiac surgery, the syndrome is seen at an average of 3 weeks but can occur any time between 3 days and 1 year.7 Pleuritic chest pain, fever, pleural or pericardial rubs, and leukocytosis are common findings.6Chest pain and fever are more common and specific to PCIS, whereas effusions following coronary artery bypass graft surgery tend to result in dyspnea with no chest pain or fever.7 Pleural effusions occur in 83% of patients.6 The fluid is often bloody with exudative characteristics and normal pH.6–7 The diagnosis of PCIS requires an appropriate history of myocardial or pericardial injury and the exclusion of other causes. The differential diagnoses include parapneumonic effusion, empyema, pulmonary embolism, and congestive heart failure. Exudative effusion with normal pH is often the clue to the diagnosis. Antiinflammatory therapy is the mainstay of the treatment for PCIS. Therapy with aspirin, ibuprofen, and indomethacin has been reported to be efficacious.7–8 Systemic corticosteroid therapy is highly effective in most patients, as in our reported case.7–8 PCIS should be considered in the patient who presented with exudative pleural effusion following PVI, especially after an infectious process and pulmonary embolism have been excluded. Cardiologists, pulmonologists, and cardiac surgeons should be wary of this potential complication, and patients should be monitored for the presence of PCIS after undergoing thoracoscopic and nonthoracoscopic PVI.