Regional pericarditis status post cardiac ablation: a case report

Area of Science:

• Cardiology
• Internal Medicine

Background:

• Regional pericarditis is challenging to diagnose and often mistaken for acute myocardial infarction.
• Healthcare providers must be aware of post-cardiac ablation complications due to the increasing prevalence of the procedure.
• Management of regional pericarditis differs significantly from acute myocardial infarction.

Observation:

• A 52-year-old male presented with chest pain after atrial fibrillation ablation, showing ECG findings indicative of myocardial infarction.
• Coronary angiography, left ventriculogram, and echocardiogram were normal, ruling out obstructive coronary disease, wall motion abnormalities, or pericardial effusion.
• The patient was diagnosed with regional pericarditis.

Findings:

• This is the first case study reporting regional pericarditis following cardiac ablation.
• ECG findings mimicked acute myocardial infarction, but invasive and imaging studies showed no coronary occlusion or ventricular dysfunction.
• Symptoms resolved with nonsteroidal anti-inflammatory agents and colchicine.

Implications:

• Electrocardiographic findings in pericarditis can be atypical and may not always present classically.
• Physicians should consider regional pericarditis in patients with chest pain post-cardiac ablation, even with "heart attack-like" ECG changes.
• Increased awareness and prompt diagnosis are vital for appropriate management of this post-procedural complication.