Postcardiac Injury Syndrome after Percutaneous Coronary Intervention

The post cardiac injury syndrome is characterized by the development of a fever, pleuropericarditis, and parenchymal pulmonary infiltrates in the weeks following trauma to the pericardium or myocardium. According to previous reports, almost all cases develop after major cardiac surgery or a myocardial infarction. Recently, a few reports have described post cardiac injury syndrome as a complication of endovascular procedures such as percutaneous cardiac intervention. Here we describe an unusual case of post cardiac injury syndrome after a percutaneous coronary intervention.

Post-cardiac injury syndrome (PCIS) following coronary artery perforation during PCI / 대한내과학회지

Post-cardiac injury syndrome (PCIS) includes post-myocardial infarction syndrome and post-pericardiotomy syndrome. PCIS is usually observed 1~6 weeks after cardiac surgery or myocardial infarction, and rarely after pacemaker implantation, coronary perforation, pulmonary thromboembolism, or radio-frequency ablation. PCIS is characterized by a low-grade fever, pleuritic chest pain, myalgia, a pericardial friction rub, increased inflammatory markers, and pericardial and pleural effusions. Although the pathophysiology of PCIS is controversial, the presence of anti-heart antibodies has implicated an autoimmune response, which has been widely accepted. The treatment of PCIS includes nonsteroidal anti-inflammatory drugs and corticosteroids. Currently, intervention is being performed increasingly in complicated obstructive coronary artery disease, such as chronic total occlusion, long-segment obstructive lesion, and left main coronary artery disease. We report a very rare case of PCIS following coronary artery perforation during PCI.