True statement regarding Dressler's Syndrome: (A) Usually occurs 1-4 days after Ml, (B) Occurs in 10% of patients with acute Ml, (C) Treatment of choice is aspirin, (D) Complication of early Pericarditis
Answer is C. Early Pericarditis Late Pericarditis (Dressler's Syndrome) 10% of patients with acute Ml. Risk factors: Transmural Ml Symptoms: Worsening of pain while supine, radiation of pain to the trapezius ridge. Physical exam: Pericardial friction rub. Diagnosis: ECG may show evidence of pericarditis; echo may show pericardial effusion Treatment: Aspirin. Avoid NSAIDs and coicosteroids (may interfere with healing of infarcted myocardium) 1-3% of patients with acute Ml. secondary to immune-medicated injury. Timing: Usually occurs 1-8 weeks after Ml. Physical exam: Pericardial rub, fever. Diagnosis: ECG may show evidence of pericarditis; echocardiography may show pericardial effusion Treatment: Aspirin. If > 4 weeks since Ml, can use NSAIDs or coicosteroids