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Pericarditis - after heart attack

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

Two types of pericarditis can occur after a heart attack.

Early pericarditis most often occurs within 1 to 3 days after a heart attack . When the body tries to clean up the diseased heart tissue, swelling and inflammation occur.

Late pericarditis is also called Dressler syndrome (or post-cardiac injury syndrome or postcardiotomy pericarditis). It usually occurs several weeks or months after a heart attack, heart surgery, or other trauma to the heart. However, it may happen a week after a heart injury. Dressler syndrome is believed to be caused by the immune system mistakenly attacking healthy heart tissue.

You have a higher risk of pericarditis if you have had a previous heart attack, open heart surgery, or chest trauma, or if your heat attack affected the thickness of your heart muscle.

Symptoms

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:

Treatment

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

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

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

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. . 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.. 9th ed. Philadelphia, Pa: Saunders; 2011:chap 75.

Little WC, Oh JK. Pericardial disease. In: Goldman L,Schafer AI, eds. . 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 77.

 

Encyclopedia content is provided as information only and not intended to replace the advice and instruction from your personal physician.