Korean J Med.  2018 Dec;93(6):565-570. 10.3904/kjm.2018.93.6.565.

Early-Onset Postcardiac Injury Syndrome after Percutaneous Coronary Intervention Recovered with Steroids

• Kim MJ
• Yoon SB
• Lee MD
• Kim SH
• Kim YW

• KMID: 2438049
• DOI: http://doi.org/10.3904/kjm.2018.93.6.565

Abstract

Postcardiac injury syndrome (PCIS) is an inflammatory process that usually occurs within 1 to 6 weeks after an injury to the pericardium, epicardium, or myocardium. As more interventions are performed for complicated coronary artery obstructive lesions, there have been some recent reports on PCIS following percutaneous coronary intervention (PCI). The medical management of PCIS depends on nonsteroidal anti-inflammatory drugs (NSAIDs), in addition to colchicine or steroids. An 80-year-old male patient underwent a PCI. Unfortunately, the guidewire piercing failed but he showed no immediate signs of complication. However, 5 hours after the procedure, he complained of chest discomfort. An electrocardiogram showed widespread ST elevation. Chest X-ray and computed tomography showed pulmonary congestion with pleural effusion, while thoracic echocardiography showed a moderate amount of pericardial effusion. NSAIDs were initiated, but there was no improvement of symptoms. We describe an unusual case of atypical earl onset PCIS after PCI, recovered rapidly by steroids.

Keyword

Postpericardiotomy syndrome; Percutaneous coronary intervention; Steroid

MeSH Terms

Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal
Colchicine
Coronary Vessels
Echocardiography
Electrocardiography
Estrogens, Conjugated (USP)
Humans
Male
Myocardium
Percutaneous Coronary Intervention*
Pericardial Effusion
Pericardium
Pleural Effusion
Postpericardiotomy Syndrome
Steroids*
Thorax
Anti-Inflammatory Agents, Non-Steroidal
Colchicine
Estrogens, Conjugated (USP)
Steroids