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Pericarditis - after heart attack


Alternative Names:

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

Symptoms:
  • 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
Signs and tests:

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:

Expectations (prognosis):

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

Complications:
Calling your health care provider:

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
References:

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.

 


Review Date: 7/11/2012
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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