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Postmyocardial syndrome after myocardial infarction and percutaneous coronary intervention

https://doi.org/10.20996/1819-6446-2024-3112

EDN: STPYHE

Abstract

Postmyocardial syndrome (Dressler syndrome) is a form of secondary pericarditis with or without pericardial effusion resulting from myocardial damage. Dressler syndrome is not a common disease, but it should be suspected in patients with pathognomonic symptoms after a myocardial infarction (MI). The article presents a clinical case of a 65-year-old man, a smoker who is overweight, with a history of hypertension, MI with ST segment elevation, stenting of the envelope branch of the left coronary artery, thrombospiration. According to coronary angiography, the patient revealed a multivessel lesion of the coronary arteries. Two weeks after stenting, the patient’s condition worsened: shortness of breath, pain in the left half of the chest, fever appeared. During the examination at the outpatient stage, bilateral hydrothorax and hydropericardium were revealed. He was hospitalized, was treated with ibuprofen 600 mg 3 times a day for 7 days, with a positive effect. Ten days after discharge, the patient noted an increase in shortness of breath, an increase in body temperature, a recurrence of dull chest pain. He was hospitalized at the Vorokhobov City Clinical Hospital No. 67, where bilateral hydrothorax, hydropericardium, pneumonitis were detected during the examination. the diagnosis "Postmyocardial syndrome, recurrent course" was established. Hospital treatment was carried out with colchicine, methylprednisolone, acetylsalicylic acid, ticagrelor, losartan, bisoprolol, amlodipine, spironolactone. Against the background of the therapy, the condition improved, the patient began to notice an increase in exercise tolerance, a gradual regression of dull chest pain on the left, body temperature decrease to subfebrile figures. Positive dynamics of laboratory parameters was noted.

About the Authors

A. A. Klimenko
Pirogov Russian National Research Medical University
Russian Federation

Alesya A. Klimenko 

 Moscow 



N. A. Demidova
Pirogov Russian National Research Medical University
Russian Federation

 Natalia A. Demidova 

 Moscow 

 



V. V. Veselkin
L. A. Vorokhobov City Clinical Hospital No. 67
Russian Federation

 Vladimir V. Veselkin 

 Moscow 



T. A. Kirdyashkina
L. A. Vorokhobov City Clinical Hospital No. 67
Russian Federation

Moscow 



A. A. Chinova
Pirogov Russian National Research Medical University
Russian Federation

 Alina A. Chinova

 Moscow
 



Yu. A. Shandanovina
Pirogov Russian National Research Medical University
Russian Federation

 Yulia A. Shandanovina 

 Moscow 



References

1. Imazio M, Hoit BD. Post-cardiac injury syndromes. An emerging cause of pericardial diseases. Int J Cardiol. 2013;168(2):648-52. DOI: 10.1016/j.ijcard.2012.09.052.

2. Russian Society of Cardiology. 2020 Clinical practice guidelines for Acute ST-segment elevation myocardial infarction. Russian Journal of Cardiology. 2020;25(11):4103 (In Russ.) DOI: 10.15829/29/1560-4071-2020-4103.

3. Arutyunov GP, Paleev FN, Tarlovskaya EI, et al. Pericarditis. Clinical recommendations of 2022. Russian Journal of Cardiology. 2023;28(3):107-67 (In Russ.) DOI: 10.15829/1560-4071-2023-5398.

4. Maisch B, Seferović PM, Ristić AD, et al; Task Force on the Diagnosis and Management of Pricardial Diseases of the European Society of Cardiology. Guidelines on the diagnosis and management of pericardial diseases executive summary. The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. Eur Heart J. 2004;25(7):587-610. DOI: 10.1016/j.ehj.2004.02.002.

5. Ginanjar E, Herdita T. Persistent ST Segment Elevation After Repeated Percutaneous Coronary Intervention: A Dressler Syndrome? Acta Med Indones. 2022;54(4):607-13.

6. Van Kolen K, Jogani S, Belmans A, Schurmans J. Fever after acute myocardial infarction: Dressler’s syndrome demonstrated on cardiac MRI. Int J Cardiol. 2015;183:209-10. DOI: 10.1016/j.ijcard.2014.12.086.

7. Zhang R, Du J, Liu M. Post-cardiac injury syndrome occurred two months after permanent dual-chamber pacemaker implantation. BMC Cardiovasc Disord. 2023;23(1):259. DOI: 10.1186/s12872-023-03252-5.

8. Aten K, Raney K, Alomar A. Dressler Syndrome: Not Just a Relic of the Past. Cureus. 2022;14(10):e30670. DOI: 10.7759/cureus.30670.

9. Jerjes-Sánchez C, Ramírez-Rivera A, Ibarra-Pérez C. The Dressler syndrome after pulmonary embolism. Am J Cardiol. 1996;78(3):343-5. DOI: 10.1016/s0002-9149(96)00290-1.

10. Khamitov RF, Latfoullin IA, Kim ZF. A case of autoimmune postinfarction Dressler syndrome. Bulletin of Modern Clinical Medicine. 2009:2(4):60-6 (In Russ.)

11. Leib AD, Foris LA, Nguyen T, Khaddour K. Dressler Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.

12. Witting MD, Hu KM, Westreich AA, et al. Evaluation of Spodick’s Sign and Other Electrocardiographic Findings as Indicators of STEMI and Pericarditis. J Emerg Med. 2020;58(4):562-9. DOI: 10.1016/j.jemermed.2020.01.017.

13. Adler Y, Charron P, Imazio M, et al; ESC Scientific Document Group. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) Endorsed by: The European Association for CardioThoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921-64. DOI: 10.1093/eurheartj/ehv318.

14. Hampton JR. Atlas of ECG. 150 clinical situations. Translated from English. M.: Medical Literature; 2007 (In Russ.).

15. Campos ID, Salgado A, Azevedo P, Vieira C. Dressler’s syndrome: are we underdiagnosing what we think to be rare? BMJ Case Rep. 2019;12(5):e227772. DOI: 10.1136/bcr-2018-227772.

16. Pyrikova NV, Antropova ON, Osipova IV. Adverse reactions from the cardiovascular system when taking nonsteroidal anti-inflammatory drugs and ways to reduce them. Rational Pharmacotherapy in Cardiology. 2019;15(5):750-8 (In Russ.). DOI: 10.20996/1819-6446-2019-15-5-750-758.

17. del Fresno MR, Peralta JE, Granados MÁ, et al. Intravenous immunoglobulin therapy for refractory recurrent pericarditis. Pediatrics. 2014;134(5):e1441-6. DOI: 10.1542/peds.2013-3900.


Review

For citations:


Klimenko A.A., Demidova N.A., Veselkin V.V., Kirdyashkina T.A., Chinova A.A., Shandanovina Yu.A. Postmyocardial syndrome after myocardial infarction and percutaneous coronary intervention. Rational Pharmacotherapy in Cardiology. 2024;20(5):581-587. (In Russ.) https://doi.org/10.20996/1819-6446-2024-3112. EDN: STPYHE

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)