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Acute MI
Acute MI


Post-MI pericarditis
Post-MI pericarditis


Pericardium
Pericardium


Definition:

Pericarditis is inflammation and swelling of the covering of the heart (pericardium). The condition can occur in the days or weeks following a heart attack.

See also: Bacterial pericarditis



Alternative Names:

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



Causes, incidence, and risk factors:

Pericarditis may occur within 2 to 5 days after a heart attack , or it may occur as much as 11 weeks later. The condition is called Dressler's syndrome when it persists for weeks or months after a heart attack.

Pericarditis that occurs shortly after a heart attack is caused by an overactive response by the body's immune system. When the body senses blood in the pericardial sac or dead or severely damaged heart tissue (as with a heart attack), it triggers an inflammatory response . Cells from the immune system try to clean up the heart after injury, but, in some cases, the cells can attack healthy tissue by mistake.

Pain occurs when the pericardium becomes inflamed (swollen) and rubs on the heart.

You have a higher risk of pericarditis if you have had a previous heart attack, open heart surgery, or chest trauma.



Symptoms:

Signs and tests:

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

Buildup of fluid in the covering of the heart or space around the lungs (pleural effusion ) is not common after heart attack. But, it does occur in some patients with Dressler's syndrome.

Tests may include:



Treatment:

The goal of treatment is to make the heart work better and reduce pain and other symptoms.

Nonsteroidal anti-inflammatory medications (NSAIDs) and aspirin may be used to treat inflammation of the pericardium. In extreme cases, when other medicines don't work, steroids or colchicine may be used.

In some cases, excess fluid surrounding the heart may need to be removed. This is done with a procedure calledpericardiocentesis . If complications develop, part of the pericardium may need to be removed with surgery (pericardiectomy).



Support Groups:



Expectations (prognosis):

The condition may come back even in those who receive treatment. However, untreated pericarditis can be life threatening.



Complications:

Calling your health care provider:

Call your health care provider if you develop symptoms of pericarditis following a heart attack.

Call your health care provider if pericarditis has been diagnosed and symptoms continue or come back, despite treatment.



Prevention:



References: LeWinter MM. Pericardial Diseases. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa; Saunders Elsevier; 2007: chap 70.


Review Date: 9/3/2008
Reviewed By: Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100