The postcardiac injury syndrome: case report and review of the literature

South Med J. 2006 Mar;99(3):309-14. doi: 10.1097/01.smj.0000203330.15503.0b.

Abstract

The postcardiac injury syndrome (PCIS) includes the postmyocardial infarction syndrome, the postcommissurotomy syndrome, and the postpericardiotomy syndrome. Dressler reported a series of patients who developed a pericarditis-like illness days to weeks after a myocardial infarction. Postcardiac injury syndrome also has been observed after cardiac surgery, percutaneous intervention, pacemaker implantation, and radiofrequency ablation. Postcardiac injury syndrome is characterized by pleuritic chest pain, low-grade fever, an abnormal chest x-ray, and the presence of exudative pericardial and/or pleural effusions. The pathophysiology of PCIS involves auto-antibodies that target antigens exposed after damage to cardiac tissue. The treatment of PCIS includes the use of nonsteroidal anti-inflammatory drugs and corticosteroids. Prophylactic use of corticosteroids before cardiac surgery has not been effective in preventing PCIS. The widespread use of reperfusion therapy and cardiac medications with anti-inflammatory properties may have reduced the incidence of PCIS. Although PCIS can follow a relapsing course, it does carry a favorable prognosis.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Cardiac Surgical Procedures / adverse effects*
  • Diagnosis, Differential
  • Echocardiography
  • Humans
  • Male
  • Postpericardiotomy Syndrome / diagnostic imaging
  • Postpericardiotomy Syndrome / etiology*
  • Radiography, Thoracic