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The postcardiac injury syndromes
1Division of Cardiology, Memorial Hospital of Rhode Island, Pawtucket 02860.
Clinical Cardiology
|February 1, 1992
Summary
Postcardiac injury syndrome (PCIS) involves inflammation after heart injury, presenting with fever and chest pain. While generally benign, rare complications can occur, and anti-inflammatory drugs are recommended treatments.
Area of Science:
- Cardiology
- Immunology
Background:
- Late pericarditis after myocardial infarction (PMIS) or cardiac surgery (PCS) is termed postcardiac injury syndrome (PCIS).
- PCIS encompasses conditions like PMIS and PCS, characterized by systemic inflammation and organ involvement.
Purpose of the Study:
- To describe the clinical presentation, etiology, and management of postcardiac injury syndrome (PCIS).
- To differentiate PCIS from similar conditions and outline treatment strategies.
Main Methods:
- Literature review of studies on postmyocardial infarction syndrome (PMIS), postcardiotomy syndrome (PCS), and postcardiac injury syndrome (PCIS).
- Analysis of clinical characteristics, laboratory findings, and radiographic evidence associated with PCIS.
Main Results:
- PCIS presents with fever, pleuropericardial pain, pericarditis, and pulmonary involvement.
- Laboratory findings include leukocytosis and elevated sedimentation rate; chest X-rays may show pleural effusion.
- An immunopathic etiology is supported, with viruses potentially contributing; the condition is typically benign but can have rare complications.
Conclusions:
- PCIS is an inflammatory condition following cardiac injury, generally with a favorable prognosis.
- Anti-inflammatory agents are beneficial, while steroids and indomethacin should be used cautiously.
- Rarely, a PMIS-like syndrome can occur post-pulmonary embolism, managed with anticoagulation and steroids.