Post cardiac injury syndrome
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: PMIS
Overview
Post cardiac injury syndrome (PCIS) encompasses two causes of pericarditis:
- Post myocardial infarction syndrome (PMIS) or Dressler's syndrome and
- Postpericardiotomy syndrome (PCS)
Pathophysiology
Both syndromes represent the delayed occurrence of pericarditis. Post-myocardial infarction syndrome is obviously due to myocardial infarction and postpericardiotomy syndrome is due to the myocardial injury that occurs during cardiac surgery. Both syndromes are thought to represent an autoimmune process with the development of anti-heart antibodies.
Natural History, Complications and Prognosis
Most often the course of PCIS is benign. Rare complications include development of cardiac tamponade, pericardial constriction, and saphenous vein graft occlusion.
Diagnosis
Symptoms
Both syndromes share common symptoms which include fever and pleuritic pain.
Physical Examination
The following findings may be present:
Cardiovascular
Lungs
Laboratory Studies
The following lab abnormalities may be present:
- An elevated erythrocyte sedimentation rate.
- A leukocytosis.
Chest x-ray
A pleural effusion with or without pulmonary infiltrates may be present.