A 65 year old man who had an MI a month ago presents with chest pain upon deep inspiration as well as malaise. He received a coronary artery bypass for the MI. Currently, exam shows a temperature of 39, a pericardial friction rub, and leukocytosis. The sed rate is increased. Sequential radiographs are shown above.Question: What is he currently suffering from?
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4 comments:
dressler's?
Postoperative atelectasis and pneumonia
pericarditis with pericardial effusion?
Yes, I think all those answers are correct.
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MI
This is Dressler’s Syndrome or postcardiac injury syndrome which occurs weeks to months after an MI. The pathogenesis is immunologic. The sequential radiographs show a pre-op clear lung (green arrow is clear left lung base), a post-op with segmental atelectasis at the left base (yellow arrow), and a left pleural effusion a month later (red arrow). A pleural or pericardial effusion is often seen in Dressler’s syndrome. Treatment is NSAIDs.
Sources: UpToDate; LearningRadiology.
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