Inspiratory Chest Pain and Fever after Acute Myocardial Infarction: Dressler's Syndrome Demonstrated on Cardiac MRI

Abstract

Introduction: Dressler’s syndrome develops in some cases several days to weeks or even months after the myocardial infarction; the incidence also seems to have declined in recent years. This syndrome is caused by an autoimmune reaction to material extracted from necrotic myocytes. Case Report: In this report, we present a case of a 72- year-old woman who was diagnosed with Dressler’s syndrome after 1 month from acute coronary syndrome. A cardiac MRI was performed, which showed features of pericarditis. The patient responded well to treatment with NSAID and colchicine and was discharged home in good general condition. Discussion: Cardiac MRI is particularly effective in identifying pericardial effusion, pericardial thickening, and inflammation-hallmarks of Dressler’s syndrome. With its ability to perform tissue characterization through T1 and T2 mapping and late gadolinium enhancement, Cardiac MRI can distinguish between active inflammation and fibrotic changes. This feature is essential in determining the stage of Dressler’s syndrome and guiding appropriate treatment. Conclusion: Due to the significant number of patients living in the community who suffered MI, underwent cardiac surgery or received cardiac implantable device placement, clinical suspicion of PCIS warrants further diagnostic evaluation using imaging modalities especially cardiac MRI for timely diagnosis and treatment.