True about Dressler's syndrome is all, except -: (A) Occurs with in hours after myocardial infarction, (B) Recurrence may be seen, (C) Chest pain is common, (D) Responds well to salicylates
Answer is A. Ans. is 'a' i.e., Occurs within hours after myocardial infarction Post-cardiac injury syndrome (Dressler's syndrome} o The post-cardiac injury syndrome has also been called Dressler's syndrome, postpericardiotomy syndrome and when occurring after myocardial infarction (MI) post myocardial infarction syndrome. o It occurs in settings other than Ml particularly after cardiac surgery or pulmonary embolism, o PCIS was first described after MI by Dressler. o It is usually a late complication developing weeks to months after acute MJ. but rarely may be evident within the first week past MJ. Dressler's syndrome develops after an internal of l -4 weeks or even months following cardiac injury (MI) and not within hours. o The clinical manifestations include : # Pleuritic chest pain # Pericardial friction rub # Fever # Leucocytosis # Pleural effusion and pulmonary infiltrates o Thus both the time course and symptoms are different from early postinfarction pericarditis. Incidence o While generally considered to have occurred infrequently the incidence of PCIS is not clear. o Before the era of reperfusion, the incidence was believed to be 3% patients post-M.I. o PCIS following MI have largely disappeared in the reperfusion era due to a decrease in the size of most M.I. Pathogenesis o Immunological factors are thoughts to be of primary importance. o Pathogenesis begins with cardiac injury and that stimulates antibody formation. The immune complexes that are generated are deposited into the pericardium, pleura, and lungs. Diagnosis o Diagnosis is made by characteristic symptoms and increased ESR. Treatment o The pericarditis usually resolves in l -2 weeks with aspirin. NSAIDs or analgesic (often no treatment is necessary). o Therapy with corticosteroids is sometimes required in resistant cases.