The postcardiac injury syndrome: case report and review of the literature.
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.
Wessman
Dylan E
DE
Department of Internal Medicine and the Division of Pulmonary and Critical Care Medicine, Naval Medical Center San Diego, San Diego, CA 92134, USA. DEWessman@nmcsd.med.navy.mil
Stafford
Christopher M
CM
D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004452:Echocardiography; D006801:Humans; D008297:Male; D011185:Postpericardiotomy Syndrome / Q000000981:diagnostic imaging / Q000209:etiology*; D013902:Radiography, Thoracic