Pericarditis and Post-cardiac Injury Syndrome as a Sequelae of Acute Myocardial Infarction
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PERICARDIAL DISEASE (L KLEIN AND CL JELLIS, SECTION EDITORS)
Pericarditis and Post-cardiac Injury Syndrome as a Sequelae of Acute Myocardial Infarction Beni R. Verma 1 & Bryce Montane 1 & Michael Chetrit 1 & Mohamed Khayata 1 & Muhammad M. Furqan 1 & Chadi Ayoub 1 & Allan L. Klein 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Pericarditis secondary to acute myocardial infarction (AMI) is known to develop either immediately or after a latent period of few months. Due to varied presentation and timing, its diagnosis and treatment can be challenging. This article reviews underlying mechanisms and the role of cardiac imaging in investigating and managing this condition. Recent Findings Timely diagnosis of pericarditis after AMI is important to prevent potential progression to complicated pericarditis. Clinical suspicion warrants initial investigation with serum inflammatory levels, electrocardiogram, and echocardiography. When findings are inconclusive, cardiac magnetic resonance imaging and computerized tomography can provide additional diagnostic information. Summary Pericarditis after AMI is a treatable condition. Clinicians should maintain a high suspicion in this era of revascularization and develop a strategic plan for timely diagnosis and management. Keywords Post-infarction pericarditis . Post-cardiac injury syndrome . Acute myocardial infarction . Percutaneous coronary intervention . Aspirin . Cardiac magnetic resonance Imaging
Abbreviations AMI Acute myocardial infarction CMR Cardiac magnetic resonance CRP C-reactive protein CT Computerized tomography DHE Delayed hyperenhancement ESC European Society of Cardiology ESR Erythrocyte sedimentation rate PCI Percutaneous coronary intervention PEff Pericardial effusion
PIP
Post infarction pericarditis
Case Presentation A 42-year-old male with history of hypertension, hyperlipidemia, and coronary artery bypass grafting developed inferolateral ST elevation myocardial infarction (STEMI) which was treated with percutaneous coronary intervention (PCI) and deployment of drug-eluting stent to the left circumflex artery. Two months after
This article is part of the Topical Collection on Pericardial Disease * Allan L. Klein [email protected]
Muhammad M. Furqan [email protected]
Beni R. Verma [email protected]
Chadi Ayoub [email protected]
Bryce Montane [email protected] Michael Chetrit [email protected] Mohamed Khayata [email protected]
1
Department of Cardiovascular Medicine and Department of Thoracic and Cardiovascular Surgery Cleveland Clinic, Center for Diagnosis and Treatment of Pericardial Disease, Cleveland Clinic, 9500 Euclid Ave., Desk J1-5, Cleveland, OH, USA
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the STEMI, he developed recurrent chest pain that was pleuritic in nature and associated with fever. Due to non-resolving symptoms, he was admitted to cardiology service for further evaluation. His electrocardiogram showed sinus rhythm with < 1 mm concave ST elevation in leads I, II, aVF, and V4–V6. Inflammatory markers wer
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