Post-cardiac injury syndromes
- Brian D Hoit, MD
Brian D Hoit, MD
- Professor of Medicine and Physiology and Biophysics
- Case Western Reserve University and University Hospitals of Cleveland
Pericarditis with or without a pericardial effusion resulting from injury of the pericardium constitutes the post-cardiac injury syndrome. Postcardiac injury syndrome was first described after myocardial infarction by Dressler in 1956 . The principal conditions considered under this rubric are:
●Postmyocardial infarction syndrome
The term "postpericardiotomy syndrome" was substituted for the previous "postcardiotomy syndrome" after it was discovered that the syndrome can occur after the pericardium is opened even if no other cardiac structures are involved (eg, after surgery for bronchogenic lung carcinoma). Furthermore, the provoking cardiac injury may be surprisingly minor (eg, percutaneous coronary intervention, insertion of a pacing lead, radiofrequency ablation) .
- DRESSLER W. A post-myocardial infarction syndrome; preliminary report of a complication resembling idiopathic, recurrent, benign pericarditis. J Am Med Assoc 1956; 160:1379.
- Wessman DE, Stafford CM. The postcardiac injury syndrome: case report and review of the literature. South Med J 2006; 99:309.
- Welin L, Vedin A, Wilhelmsson C. Characteristics, prevalence, and prognosis of postmyocardial infarction syndrome. Br Heart J 1983; 50:140.
- Lichstein E, Arsura E, Hollander G, et al. Current incidence of postmyocardial infarction (Dressler's) syndrome. Am J Cardiol 1982; 50:1269.
- Shahar A, Hod H, Barabash GM, et al. Disappearance of a syndrome: Dressler's syndrome in the era of thrombolysis. Cardiology 1994; 85:255.
- Tsang TS, Barnes ME, Hayes SN, et al. Clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery and outcomes of echo-guided pericardiocentesis for management: Mayo Clinic experience, 1979-1998. Chest 1999; 116:322.
- Imazio M, Hoit BD. Post-cardiac injury syndromes. An emerging cause of pericardial diseases. Int J Cardiol 2013; 168:648.
- Khan AH. The postcardiac injury syndromes. Clin Cardiol 1992; 15:67.
- De Scheerder I, De Buyzere M, Robbrecht J, et al. Postoperative immunological response against contractile proteins after coronary bypass surgery. Br Heart J 1986; 56:440.
- Nomura Y, Yoshinaga M, Haraguchi T, et al. Relationship between the degree of injury at operation and the change in antimyosin antibody titer in the postpericardiotomy syndrome. Pediatr Cardiol 1994; 15:116.
- Engle MA, Zabriskie JB, Senterfit LB, et al. Viral illness and the postpericardiotomy syndrome. A prospective study in children. Circulation 1980; 62:1151.
- Bartels C, Hönig R, Burger G, et al. The significance of anticardiolipin antibodies and anti-heart muscle antibodies for the diagnosis of postpericardiotomy syndrome. Eur Heart J 1994; 15:1494.
- Hoffman M, Fried M, Jabareen F, et al. Anti-heart antibodies in postpericardiotomy syndrome: cause or epiphenomenon? A prospective, longitudinal pilot study. Autoimmunity 2002; 35:241.
- Kim S, Sahn SA. Postcardiac injury syndrome. An immunologic pleural fluid analysis. Chest 1996; 109:570.
- Cabalka AK, Rosenblatt HM, Towbin JA, et al. Postpericardiotomy syndrome in pediatric heart transplant recipients. Immunologic characteristics. Tex Heart Inst J 1995; 22:170.
- Imazio M, Brucato A, Rovere ME, et al. Contemporary features, risk factors, and prognosis of the post-pericardiotomy syndrome. Am J Cardiol 2011; 108:1183.
- Kan CD, Wang JN, Wu JM, Yang YJ. Isolated chylopericardium after intrapericardial procedures: possible role of inadvertent right efferent lymphatic trunk injury. Tex Heart Inst J 2007; 34:82.
- Weitzman LB, Tinker WP, Kronzon I, et al. The incidence and natural history of pericardial effusion after cardiac surgery--an echocardiographic study. Circulation 1984; 69:506.
- DRESSLER W. The post-myocardial-infarction syndrome: a report on forty-four cases. AMA Arch Intern Med 1959; 103:28.
- Khan AH. Pericarditis of myocardial infarction: review of the literature with case presentation. Am Heart J 1975; 90:788.
- Imazio M, Trinchero R, Brucato A, et al. COlchicine for the Prevention of the Post-pericardiotomy Syndrome (COPPS): a multicentre, randomized, double-blind, placebo-controlled trial. Eur Heart J 2010; 31:2749.
- Imazio M, Brucato A, Markel G, et al. Meta-analysis of randomized trials focusing on prevention of the postpericardiotomy syndrome. Am J Cardiol 2011; 108:575.
- Finkelstein Y, Shemesh J, Mahlab K, et al. Colchicine for the prevention of postpericardiotomy syndrome. Herz 2002; 27:791.
- Bunge JJ, van Osch D, Dieleman JM, et al. Dexamethasone for the prevention of postpericardiotomy syndrome: A DExamethasone for Cardiac Surgery substudy. Am Heart J 2014; 168:126.
- Imazio M, Brucato A, Ferrazzi P, et al. Colchicine for prevention of postpericardiotomy syndrome and postoperative atrial fibrillation: the COPPS-2 randomized clinical trial. JAMA 2014; 312:1016.
- Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2015; 36:2921.
- Imazio M, Spodick DH, Brucato A, et al. Controversial issues in the management of pericardial diseases. Circulation 2010; 121:916.
- Alraies MC, Al Jaroudi W, Shabrang C, et al. Clinical features associated with adverse events in patients with post-pericardiotomy syndrome following cardiac surgery. Am J Cardiol 2014; 114:1426.
- Izadi Amoli A, Bozorgi A, HajHossein Talasaz A, et al. Efficacy of colchicine versus placebo for the treatment of pericardial effusion after open-heart surgery: A randomized, placebo-controlled trial. Am Heart J 2015; 170:1195.
- Meurin P, Lelay-Kubas S, Pierre B, et al. Colchicine for postoperative pericardial effusion: a multicentre, double-blind, randomised controlled trial. Heart 2015; 101:1711.
- Maisch B, Ristić AD, Pankuweit S. Intrapericardial treatment of autoreactive pericardial effusion with triamcinolone; the way to avoid side effects of systemic corticosteroid therapy. Eur Heart J 2002; 23:1503.
- Trinkle JK, Toon RS, Franz JL, et al. Affairs of the wounded heart: penetrating cardiac wounds. J Trauma 1979; 19:467.
- Harris DG, Janson JT, Van Wyk J, et al. Delayed pericardial effusion following stab wounds to the chest. Eur J Cardiothorac Surg 2003; 23:473.
- Fulda G, Brathwaite CE, Rodriguez A, et al. Blunt traumatic rupture of the heart and pericardium: a ten-year experience (1979-1989). J Trauma 1991; 31:167.
- Ruder MA, Flaker GC, Alpert MA, Selmon MR. Right ventricular myocardial contusion simulating constrictive pericardial disease. Am Heart J 1984; 108:1353.
- Fallahnejad M, Kutty AC, Wallace HW. Secondary lesions of penetrating cardiac injuries: a frequent complication. Ann Surg 1980; 191:228.
- Shabetai R, Aravindakshan V, Danielson G, Bryant L. Traumatic hemopericardium with tricuspid incompetence. J Thorac Cardiovasc Surg 1969; 57:294.
- Roebuck EJ, Minford J. Traumatic rupture of the pericardium with herniation of the heart. Br J Radiol 1983; 56:585.
- Tsang TS, Freeman WK, Barnes ME, et al. Rescue echocardiographically guided pericardiocentesis for cardiac perforation complicating catheter-based procedures. The Mayo Clinic experience. J Am Coll Cardiol 1998; 32:1345.
- CLINICAL FEATURES
- Laboratory testing
- Chest radiograph
- DIFFERENTIAL DIAGNOSIS
- PREVENTION AND TREATMENT
- - Colchicine
- - Glucocorticoids
- - NSAIDs
- - Colchicine
- - Treatment for refractory cases
- PROGNOSIS AND FOLLOW-UP
- PERICARDIAL TRAUMA
- Blunt trauma
- Iatrogenic trauma
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS