Dressler syndrome and post-cardiac injury syndrome

At a glance

• Post-cardiac injury syndrome (PCIS) is the ESC umbrella for pericarditis that follows injury to the heart: Dressler syndrome after MI, post-pericardiotomy syndrome after cardiac surgery, and post-traumatic pericarditis, which today is mostly iatrogenic (PCI perforation, pacemaker leads, AF ablation).
• It is immune-mediated. The latent period of weeks, the response to anti-inflammatory drugs and the tendency to recur all point that way.
• Dressler syndrome is now under 1% of MIs in the reperfusion era, mostly after large infarcts or late reperfusion. Post-pericardiotomy syndrome is far more common, roughly 10 to 30% after cardiac surgery.