Early post-acute myocardial infarction (AMI) pericarditis, pericardial effusion with or without cardiac tamponade, and late post-MI pericarditis (Dressler syndrome), are the major pericardial complications after AMI. ...Early post-acute myocardial infarction (AMI) pericarditis, pericardial effusion with or without cardiac tamponade, and late post-MI pericarditis (Dressler syndrome), are the major pericardial complications after AMI. It is quite rare and estimated to be only about 0.1% in AMI patients according to a recent report, so it is easily neglected or misdiagnosed and may have tragic result to patient. Clinical features of this post-AMI complication include fever, chest pain, pericarditis and pleurisy occurring 2 to 3 weeks after AMI. Dressler syndrome is rarely associated with left ventricular aneurysm. Contrast enhanced magnetic resonance and echocardiography play important roles in diagnosis of left ventricle aneurysm. We report a 54-year-old male heavy labor worker who had asymptomatic, severe coronary artery disease, complicated with silent myocardial infarction, which resulted in large left ventricular aneurysm, and also systolic heart failure was noted. Patient was diagnosed to have Dressler syndrome after his second cardiology clinic follow-up. He received coronary angiography which revealed triple vessel disease with total occlusion of left anterior descending artery, and a giant left ventricular aneurysm was found. He received surgical intervention with Batista method and followed-up uneventfully at the cardiology clinic.展开更多
We present the case of an unusual presentation of Dressler’s syndrome and the important role of new imaging techniques in its diagnosis. A 42-year-old man was admitted with progressive dyspnoea and pleuritic chest pa...We present the case of an unusual presentation of Dressler’s syndrome and the important role of new imaging techniques in its diagnosis. A 42-year-old man was admitted with progressive dyspnoea and pleuritic chest pain during the last two months. Physical examination showed signs of hemodynamic instability (BP 75/40, HR 120 bpm). X-Ray showed cardiomegaly and electrocardiogram was suggestive of chronic anterior myocardial infarction. Transthoracic echocardiography showed pericardial effusion with signs of hemodynamic compromise. Emergent cardiac surgery was performed with suspicion of cardiac rupture. Only fibrinous material and serous fluid was found. 72 hours later he required reoperation because of recurrence of cardiac tamponade. Pleuropericardial window was made. Anti-inflammatory treatment was initiated. At discharge a magnetic resonance imaging study was performed. Diffuse pericardial inflammation consistent with a diagnosis of Dressler’s syndrome (DS) was demonstrated in T2- weighted black-blood and late enhancement sequences. One month later neither pleural nor pericardial effusion had recurred. Postinfarction pericardial effusions are common and magnetic resonance imaging has proven useful in determining its aetiology.展开更多
文摘Early post-acute myocardial infarction (AMI) pericarditis, pericardial effusion with or without cardiac tamponade, and late post-MI pericarditis (Dressler syndrome), are the major pericardial complications after AMI. It is quite rare and estimated to be only about 0.1% in AMI patients according to a recent report, so it is easily neglected or misdiagnosed and may have tragic result to patient. Clinical features of this post-AMI complication include fever, chest pain, pericarditis and pleurisy occurring 2 to 3 weeks after AMI. Dressler syndrome is rarely associated with left ventricular aneurysm. Contrast enhanced magnetic resonance and echocardiography play important roles in diagnosis of left ventricle aneurysm. We report a 54-year-old male heavy labor worker who had asymptomatic, severe coronary artery disease, complicated with silent myocardial infarction, which resulted in large left ventricular aneurysm, and also systolic heart failure was noted. Patient was diagnosed to have Dressler syndrome after his second cardiology clinic follow-up. He received coronary angiography which revealed triple vessel disease with total occlusion of left anterior descending artery, and a giant left ventricular aneurysm was found. He received surgical intervention with Batista method and followed-up uneventfully at the cardiology clinic.
文摘We present the case of an unusual presentation of Dressler’s syndrome and the important role of new imaging techniques in its diagnosis. A 42-year-old man was admitted with progressive dyspnoea and pleuritic chest pain during the last two months. Physical examination showed signs of hemodynamic instability (BP 75/40, HR 120 bpm). X-Ray showed cardiomegaly and electrocardiogram was suggestive of chronic anterior myocardial infarction. Transthoracic echocardiography showed pericardial effusion with signs of hemodynamic compromise. Emergent cardiac surgery was performed with suspicion of cardiac rupture. Only fibrinous material and serous fluid was found. 72 hours later he required reoperation because of recurrence of cardiac tamponade. Pleuropericardial window was made. Anti-inflammatory treatment was initiated. At discharge a magnetic resonance imaging study was performed. Diffuse pericardial inflammation consistent with a diagnosis of Dressler’s syndrome (DS) was demonstrated in T2- weighted black-blood and late enhancement sequences. One month later neither pleural nor pericardial effusion had recurred. Postinfarction pericardial effusions are common and magnetic resonance imaging has proven useful in determining its aetiology.
