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Pericarditis - after heart attack
Alternative namesDressler's syndrome; Post-MI pericarditis; Post-cardiac injury syndrome; Postcardiotomy pericarditis
DefinitionPericarditis is an inflammation and swelling of the pericardium (the sac-like covering of the heart), which can occur in the days or weeks following a heart attack.
Causes, incidence, and risk factors
Pericarditis may occur within 2 to 5 days after a heart attack (acute MI), or it may occur as much as 11 weeks later. The condition is called Dressler's syndrome when it persists for weeks or months after a heart attack. Pericarditis can also be caused by open heart surgery , stab wounds to the heart and blunt chest trauma. It may involve repeated episodes of symptoms.
Signs and tests
Using a stethoscope, the doctor will listen for a pericardial rubbing sound (not be confused with a murmur), and heart sounds may be weak or distant. Collections of fluid in the pericardial sac or in the space around the lungs ( pleural effusion ) are not common after heart attack. They do occur with chronic post-MI pericarditis (Dressler's syndrome).
The goal is to improve the function of the heart and reduce symptoms.
Nonsteroidal anti-inflammatory medications (NSAIDS) and aspirin may be used to relieve inflammation of the pericardium. In extreme cases, when other medicines have failed, steroids or colchicine may be used. Other medications may include analgesics to relieve pain.
The removal of excess fluid from the pericardial sac ( pericardiocentesis ) may be recommended in some cases. Cutting or surgical removal of part of the pericardium (surgical pericardiectomy) is only implemented if complications develop.
Expectations (prognosis)This disorder may cause severe symptoms or even be life-threatening if untreated. Recurrences are common even with adequate treatment.
Calling your health care provider
Call your health care provider if symptoms of pericarditis occur following a heart attack.
Call your health care provider if pericarditis has been diagnosed and symptoms persist or recur despite treatment.
Update Date: 11/11/2002Thippeswamy H. Murthy, M.D., Division of Cardiology, Washington Hospital Center, Washington, DC. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT