Presentation
The data presented document that pleuropulmonary involvement is a common manifestation of postcardiac injury syndrome. [ncbi.nlm.nih.gov]
Moreover, it has never been reported that PCIS presenting as mediastinitis occurs after an AMI. Our case is the first case of PCIS presenting as acute mediastinitis. [synapse.koreamed.org]
Entire Body System
- Congestive Heart Failure
In addition, we discuss how these findings can be used to differentiate this syndrome from other clinical entities that may appear following cardiac injury, ie, parapneumonic effusions, congestive heart failure, and pulmonary embolism. [ncbi.nlm.nih.gov]
There are no other signs of conge st ive heart failure. [learningradiology.com]
Congestive Heart Failure. Available online at http://www.emedicinehealth.com/congestive_heart_failure/page5_em.htm#Exams%20and%20Tests.Accessed October 2008. MayoClinic.com. Heart failure: Symptoms. [labtestsonline.it]
These include pneumonia, pulmonary embolism, angina, congestive heart failure (CHF), and heart attack. A doctor may suspect you have Dressler syndrome if you start feeling ill a few weeks after a heart surgery or heart attack. [healthline.com]
[…] from SoSanguineRN Cardiac Nursing Nursing Career Nursing Schools Nursing Students Cardiovascular Nursing Np School School Stuff Chf Treatment Stages Of Heart Failure Forward Medical Pharmacology: Principles of Congestive Heart Failure and Drugs Used to [pinterest.it]
- Surgical Procedure
Therefore, early identification of these patients could allow medical treatment and might help avoid the need for a surgical procedure. Cardiologists should remember that this uncommon syndrome can occur after routine endovascular procedures. [ncbi.nlm.nih.gov]
In modern practice, however, most cases of mediastinitis are complications of cardiovascular or thoracic surgical procedures. 11 - 13) The radiologic hallmark of non-postoperative mediastinitis is mediastinal widening on chest X-ray. [synapse.koreamed.org]
procedures within the preceding weeks. [ citation needed ] Treatment [ edit ] Dressler syndrome is best treated with high dose aspirin. [en.wikipedia.org]
procedure (on) T81.9 ICD-10-CM Diagnosis Code T81.9 Unspecified complication of procedure 2016 2017 2018 2019 Non-Billable/Non-Specific Code postcardiotomy syndrome I97.0 postcommissurotomy syndrome I97.0 postvalvulotomy syndrome I97.0 Injury T14.90 [icd10data.com]
PCIS occurs several days to several months after the surgical procedure. The syndrome manifests itself as exudative pericardial or pleural effusion with low-grade temperature and elevated inflammatory parameters. [termedia.pl]
- Gangrene
ICD-10-CM Codes Adjacent To I97.0 I95.0 Idiopathic hypotension I95.1 Orthostatic hypotension I95.2 Hypotension due to drugs I95.3 Hypotension of hemodialysis I95.8 Other hypotension I95.81 Postprocedural hypotension I95.9 Hypotension, unspecified I96 Gangrene [icd10data.com]
Clostridial Gas Gangrene. Medscape Reference. Available online at http://emedicine.medscape.com/article/214992-overview. Accessed February 2017. Fonti utilizzate nelle revisioni precedenti Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). [labtestsonline.it]
- Epilepsy
Epilepsy Res. 2013;106:396–402. doi: 10.1016/j.eplepsyres.2013.06.018. ↩ Randomized clinical study of thiopental loading in comatose survivors of cardiac arrest. Brain Resuscitation Clinical Trial I Study Group. [eccguidelines.heart.org]
Respiratoric
- Pleuritic Pain
The disease consists of a persistent low-grade fever, chest pain (usually pleuritic in nature), pericarditis (usually evidenced by a pericardial friction rub ), and/or a pericardial effusion. [en.wikipedia.org]
Symptoms include: chest pain that’s worse when lying down chest pain that worsens with deep breathing or coughing (pleuritic pain) fever difficult or labored breathing fatigue decreased appetite Dressler syndrome is difficult to diagnose because its symptoms [healthline.com]
Introduction Post pericardiotomy syndrome (PPS) was first described in 1953 in patients who developed fever and pleuritic pain after undergoing mitral valve surgery 1. [acc.org]
pain, friction rubs, pleural effusions, pneumonitis, and abnormal ECG and radiography findings (see Workup). [emedicine.medscape.com]
Cardiovascular
- Chest Pain
Four hours after the procedure, the patient developed pleuritic chest pain, with a low-grade fever. [amjmed.org]
One should consider this diagnosis after coronary angioplasty when the patient develops sudden chest pain and if the chest CT reveals pericardial thickening with small gas bubbles. [synapse.koreamed.org]
The case adds a differential diagnosis to chest pain and malaise following PTCA. [ncbi.nlm.nih.gov]
- Heart Failure
In addition, we discuss how these findings can be used to differentiate this syndrome from other clinical entities that may appear following cardiac injury, ie, parapneumonic effusions, congestive heart failure, and pulmonary embolism. [ncbi.nlm.nih.gov]
CHAPTER 48 Coronary artery bypass graft surgery 430 CHAPTER 49 Cardiogenic shock in patients with acute coronary syndromes 441 CHAPTER 50 Gender considerations in acute coronary syndromes 449 SECTION VII Acute heart failure 457 epidemiology classification [books.google.es]
There are no other signs of conge st ive heart failure. [learningradiology.com]
- Heart Disease
Clinical Topics: Arrhythmias and Clinical EP, Cardiac Surgery, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pericardial Disease, Genetic Arrhythmic Conditions, Cardiac Surgery and Arrhythmias [acc.org]
Postpericardiotomy syndrome following surgery for nonrheumatic heart disease. Circulation. 1958;17(4, Part 1):549–56. PubMed CrossRef Google Scholar 6. Kaye D, Frankl W, Arditi LI. [link.springer.com]
Pericardial diseases. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier Saunders; 2019:chap 83. Little WC, Oh JK. [medlineplus.gov]
Other NSAIDs though once used to treat Dressler syndrome, are less advocated and should be avoided in patients with ischemic heart disease. [en.wikipedia.org]
- Thrombosis
It is thought that spilled blood, bleeding and its contact with serosal surface has an irritating effect inducing thrombosis, inflammation and fibrosis. [hvt-journal.com]
Obviously, this has to be distinguished from the focal hypocontractility caused by a coronary thrombosis, which evolves on its own. [annalsofintensivecare.springeropen.com]
- Retrosternal Chest Pain
chest pain, often radiating to the neck, shoulders, or back. [clevelandclinicmeded.com]
Skin
- Ulcer
Post-arrest gastric ulceration Apart having their stomach lacerated or ruptured during CPR, post-arrest patients can suffer ulceration of the gastric mucosa. [derangedphysiology.com]
Workup
Multimodality cardiovascular imaging and diagnostic work-up 4.1 Multimodality imaging 4.1.1 Chest X-ray 4.1.2 Echocardiography 4.1.6 Cardiac catheterization 4.1.7 Multimodality imaging 4.2 Proposal for a general diagnostic workup 5. [escardio.org]
He had extensive testing, including workup for ischemic heart disease. A left heart catheterization was done, revealing non-obstructive coronary artery disease. [cureus.com]
[…] or late postoperative cardiac tamponade [15] and even recurrent cardiac tamponade. [16] The syndrome is also characterized by pericardial or pleuritic pain, friction rubs, pleural effusions, pneumonitis, and abnormal ECG and radiography findings (see Workup [emedicine.medscape.com]
X-Ray
- Pericardial Effusion
Among them, 6 patients (6/21, 28.6%) were diagnosed with PCIS secondary to cardiac perforation because they also developed pleural effusions (6/6, 100%) and fever (4/6, 66.7%) in addition to pericardial effusion/tamponade. [ncbi.nlm.nih.gov]
Among them, 6 patients (6/21, 28.6%) were diagnosed with PCIS secondary to cardiac perforation because they also developed pleural effusion (6 pts, 100%) and fever (4 pts, 66.7%) in addition to pericardial effusion/tamponade. [circ.ahajournals.org]
QT, RR, ST Intervals
- ST Elevation
Postcardiac injury syndrome Acute Pericarditis After Percutaneous Coronary Intervention Mimicking Inferolateral ST-Elevation Myocardial Infarction January 29, 2013 The authors describe a rare case of postcardiac injury syndrome manifesting as acute pericarditis [invasivecardiology.com]
ECG demonstrating global ‘saddle shaped’ ST elevation consistent with pericarditis (C). Chest radiography showing bilateral pleural effusion (D). [amjmed.org]
[…] outcome associated with emergency coronary angiography in patients with ST elevation after cardiac arrest. 19 - 21, 24, 26 - 29, 31 Fewer data are available to evaluate coronary angiography in patients without ST elevation on the initial ECG. [eccguidelines.heart.org]
Originating from S wave Concave upwards Lead V 6 : ST-T amplitude >0.24 mm Focal—vascular territory Originating from R wave Convex upwards ST depression Lead aV R only Present; reciprocal changes to ST elevation according to territory PR segment Leads [clevelandclinicmeded.com]
"Primary percutaneous coronary intervention and mild induced hypothermia in comatose survivors of ventricular fibrillation with ST-elevation acute myocardial infarction." Resuscitation 74.2 (2007): 227-234. Menegazzi, James J. [derangedphysiology.com]
Treatment
Get clear, concise descriptions and evidence-based treatment guidelines for a full range of clinical conditions, ranging from the common to the unusual. [books.google.com]
In spite of receiving anti-inflammatory treatment, the patient developed relapsing PCIS. [ncbi.nlm.nih.gov]
Dressler's syndrome also may respond to treatment with colchicine, a drug commonly used to treat acute gout. If these measures fail, a short course of treatment with steroids, such as prednisone, is virtually always effective. [verywell.com]
Prognosis
Although PCIS can follow a relapsing course, it does carry a favorable prognosis. [ncbi.nlm.nih.gov]
Pericardial syndromes 3.1 Acute pericarditis 3.1.1 Clinical management and therapy 3.1.2 Prognosis 3.2 Incessant and chronic pericarditis 3.3 Recurrent pericarditis 3.3.1 Therapy 3.3.2 Prognosis 3.4 Pericarditis associated with myocardial involvement [escardio.org]
Advances in cardiopulmonary resuscitation enable progress in management of post-cardiac arrest syndrome, but the overall prognosis after cardiac arrest has not improved. [e-jnc.org]
Non-neoplastic diseases are presented according to epidemiology, genetics, clinical manifestations, radiographic findings, pathology, cytology, laboratory findings, pathogenesis, differential diagnosis, prognosis and natural history. [books.google.de]
The prognosis of the PCIS is relatively good for most patients; however, 10 to 15% of cases will experience a recurrence 5. [immunologyresearchjournal.com]
Etiology
BACKGROUND: Postcardiac injury syndrome (PCIS) is a complication of a variety of cardiac injuries, of which small heart perforation is the etiology that is often unrecognized. [ncbi.nlm.nih.gov]
Other tests are performed based on clinical suspicion of a specific etiology or to exclude certain etiologies. [brown.edu]
Abstract Background Postcardiac injury syndrome (PCIS) is a complication of a variety of cardiac injuries, of which minor perforation of the heart with a cardiac catheter is a rare, under-recognized etiology. [circ.ahajournals.org]
Etiology The most common form of acute pericarditis is idiopathic, which accounts for about 90% of cases ( Box 1 ). [clevelandclinicmeded.com]
Magnetic resonance imaging (MRI) may be useful when trying to establish the etiology of post-myocardial infarction pericardial effusion. 2. [file.scirp.org]
Epidemiology
Epidemiology, aetiology and classification of pericardial diseases 2.1 Epidemiology 2.2 Aetiology 3. [escardio.org]
Non-neoplastic diseases are presented according to epidemiology, genetics, clinical manifestations, radiographic findings, pathology, cytology, laboratory findings, pathogenesis, differential diagnosis, prognosis and natural history. [books.google.de]
Risk Factors for PPS The earliest epidemiologic study aimed at identifying those at risk of PPS included 994 patients who underwent cardiothoracic surgery at Johns Hopkins between November of 1984-1985 12. [acc.org]
CHAPTER 48 Coronary artery bypass graft surgery 430 CHAPTER 49 Cardiogenic shock in patients with acute coronary syndromes 441 CHAPTER 50 Gender considerations in acute coronary syndromes 449 SECTION VII Acute heart failure 457 epidemiology classification [books.google.es]
The epidemiology of the postpericardiotomy syndrome: A common complication of surgery. American Heart Journal, 116, 1323–1329. PubMed CrossRef Google Scholar 5. Hargreaves, M., & Bashir, Y. (1994). [link.springer.com]
Pathophysiology
The pathophysiology of PCIS involves auto-antibodies that target antigens exposed after damage to cardiac tissue. The treatment of PCIS includes the use of nonsteroidal anti-inflammatory drugs and corticosteroids. [ncbi.nlm.nih.gov]
This thoroughly reworked edition includes new classification schemes and the latest understanding of the pathophysiology and molecular aspects of a wide range of diseases. [books.google.de]
Although this matter is not recent, the pathophysiology of post-arrest adrenal insufficiency has not been elucidated. [wjgnet.com]
Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International Liaison Committee on Resuscitation. Circulation. 2008 Dec 2;118(23):2452-83. [lifeinthefastlane.com]
Post-cardiac arrest syndrome, a new term proposed by the authors of the statement, “is a unique and complex combination of pathophysiological processes,” they said. [mdedge.com]
Prevention
Several strategies (aspirin, corticosteroids, colchicine) have beenexamined in clinical trials for primary prevention of post-pericardiotomy syndrome 22 .In the COlchicine for the Prevention of the Post-pericardiotomy Syndrome (COPPS) trial colchicine [immunologyresearchjournal.com]
Prophylactic use of corticosteroids before cardiac surgery has not been effective in preventing PCIS. The widespread use of reperfusion therapy and cardiac medications with anti-inflammatory properties may have reduced the incidence of PCIS. [ncbi.nlm.nih.gov]
Colchicine for the prevention of postpericardiotomy syndrome. Herz. 2002 Dec;27(8):791-4. [escardio.org]
The use of colchicine for prevention of PPS has been tested in 2 large randomized control trials. [acc.org]