post mi pericarditis

8/17/2019 Post MI Pericarditis

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Post-MI Pericarditis Dressler’s syndrome /Post Cardiotomy syndrome

-Autoimmune reaction to myocardial damage- Occur 2-10 weeks after !"MI

Clinical features#

$ecurrent fe%er&

s'ar( central c'est (ain aggra%ated )y mo%ement and lying down res(iration

$elie%ed )y leaning forward

* (leural or (ericardial ru) + )est 'eard at ,," at t'e end of e(iration wit' t'e (atientleaning forward. uiet due to massi%e (ericardial eusion w'ic' (us' t'e (ericardiuma(art

Investigation:

-"C# addle ! ele%ation +nterior and inferior.& $eci(rocal ! de(recissoon& ! wa%ede(ression

-Cardiac en3yme may ele%ated in myocarditis-C'est ray# Cardiomegaly& * Pericardial eusion& enlarged glo)ular 'eart & eclude

tu)erculous cause of (ericarditis

Treatment

4ed rest

5ig' dose oral s(irin 600mg 7-8/day

Pericarditis:


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Pericardial "usion 9 Caridiac

!em(onade Pericardial eusion# :luid collection

wit'in t'e (otentioal s(ace in t'e(ericardial sac;

Pericarditis ecess In


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Cardiac Temponade Ot'er causes of Cardiac !em(onade#

-Malignant disease& !rauma& $u(ture of Myocardial wall following MI

Clinical :eatures of Cardiac !em(onade#

Dys(noea&Colla(se& 'y(otension& !ac'ycardia&

ross ele%ation of t'e =>P& soft 'eart sound wit' an early 7rd 'eartsound&

Pulsus (aradous +,arge fall in 4P during ins(iration& ?ussmaul’s sign+ =%(@ during res(iration.&

:riedric'As sign +stee( /y descent.

In%estigation #

-"C# s'ows underlying disease of (ericarditis/ acute MI& $altrernans

-"c'ocardiogram# Diastolic colla(se of rig't atrium and %entricle reBuire urgent (ericardiocentesis

-Percardial )io(sy +sus(ected !4.

!reatment#

-Pericardiocentatsiis-Precardial fenestration+ creation of window in t'e ericardium.


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Do((ler ec'ocardiogram

post mi pericarditis

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