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.
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
Cardiovascular: A pericardial friction rub may be present it's Lungs: A pleural effusion may be present.
= = Laboratory Studies = =
- An elevated sedimentation rate may be present.
- A leukocytosis is often present.
= = Chest x-ray = =
A pleural effusion with or without pulmonary infiltrates may be present.
Evidence supports an immunopathic etiology; viruses may play a contributing role. Anti-inflammatory agents are helpful; indo-methacin and steroids are preferably avoided. Rarely, PMIS-like syndrome may occur following pulmonary embolism. Anticoagulation and steroids have been used successfully in the latter situation.