Post myocardial infarction pericarditis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: post MI pericarditis
Overview
Post MI pericarditis occurs in 17% to 25% of patients 2 to 4 days following an MI.
Epidemiology and Demographics
Post MI pericarditis occurs in 17 to 25% of cases of acute myocardial infarction.
Differentiating Post MI Pericarditis from other Conditions
Post myocardial infarction pericarditis occurs between days 2 and 4 after the myocardial infarction. In contrast, Dressler's syndrome typically occurs 2 to 10 weeks after a myocardial infarction has occurred[1]. Post MI pericarditis also needs to be differentiated from pulmonary embolism, another identifiable cause of pleuritic (and non-pleuritic) chest pain in people who have been hospitalized and/or undergone surgical procedures within the preceding weeks.
Treatment
Post MI pericarditis is typically treated with high dose (up to 650 mg PO q 4 to 6 hours) enteric-coated aspirin. Acetominophen can be added for pain management as this does not affect the coagulation system. Anticoagulants should be discontinued if the patient develops a pericardial effusion.
NSAIDs such as ibuprofen should be avoided in the peri-infarct period as they:
- Increase the risk of reinfarction
- Adversely impact left ventricular remodeling
- Block the effectiveness of aspirin
References
- ↑ Krainin F, Flessas A, Spodick D (1984). "Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram". N Engl J Med. 311 (19): 1211–4. PMID 6493274.