Dressler syndrome; Post-MI pericarditis; Post-cardiac injury syndrome; Postcardiotomy pericarditis

• Anxiety
• Chest pain occurs when the pericardium becomes swollen and rubs on the heart.
  • May come and go (recur)
  • Pain may be sharp and stabbing (pleuritic) or tight and crushing (ischemic)
  • Pain may get worse when breathing and may go away when you lean forward, stand, or sit up
  • Pain moves to the neck, shoulder, back, or abdomen
• Difficulty breathing
• Dry cough
• Fast heart rate (tachycardia)
• Fatigue
• Fever (more common with the second type of pericarditis)
• Malaise (general ill feeling)
• Splinting of ribs (bending over or holding the chest) with deep breathing

The health care provider will use a stethoscope to listen to your heart and lungs. There may be a rubbing sound (called a pericardial friction rub, not to be confused with a heart murmur). Heart sounds in general may be weak or sound far away.

A buildup of fluid in the covering of the heart or space around the lungs (pericardial effusion) is not common after a heart attack. But, it often does occur in some patients with Dressler syndrome.

Tests may include:

• Cardiac injury markers (CK-MB and troponin may help tell pericarditis from a heart attack)
• Chest CT scan
• Chest MRI
• Chest x-ray
• Complete blood count
• ECG
• Echocardiogram
• ESR (sedimentation rate) or C-reactive protein (measures of inflammation)

The condition may come back, even in people who receive treatment. In some cases, untreated pericarditis can be life threatening.

• Cardiac tamponade
• Congestive heart failure
• Constrictive pericarditis

Call your health care provider if:

• You develop symptoms of pericarditis after a heart attack
• You have been diagnosed with pericarditis and symptoms continue or come back, despite treatment

Anderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, SchaferAI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier;2011:chap 73.

LeWinter MM, Tischler MD. Pericardial diseases. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders; 2011:chap 75.

Little WC, Oh JK. Pericardial disease. In: Goldman L,Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 77.