Dressler Syndrome, though rare in the reperfusion era, must still be considered in the differential diagnosis of chest pain following an ischemic event.
Supports considering Dressler syndrome in post-MI chest pain; leaves open its incidence in the reperfusion era.
Introduction: Dressler Syndrome should be considered in the differential diagnosis of chest pain, especially in patients who are in a late stage of the evolution of the ischemic process. Case Presentation: A 46-year-old male was admitted to the emergency department due to pleuritic chest pain. Two weeks before this admission, he presented with a typical angina episode, likely an ST segment elevation myocardial infarction (STEMI), and did not receive reperfusion therapy or any medical care. The patient's electrocardiogram showed diffuse ST segment elevation and PR segment depression, and his blood tests showed positive myocardial necrosis markers. A coronary angiography showed a proximal occlusion (not recanalized) of the circumflex artery. There was a late gadolinium enhancement area seen through cardiac magnetic resonance imaging (CMR), suggestive of recent transmural infarction, pericardial injury, and pleural effusion (inflammatory). Conclusions: These findings strongly suggest the diagnosis of delayed post-infarction pericarditis, or Dressler Syndrome, a rare disease in the age of reperfusion therapy. Although rare, it is a syndrome that must be considered in the differential diagnosis of chest pain.
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Macedo et al. (2015) studied this question.
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