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      Dressler's syndrome demonstrated by late gadolinium enhancement cardiovascular magnetic resonance

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          Abstract

          A 49-year old patient presented late with an anterolateral ST-elevation myocardial infarction and was treated with rescue angioplasty to an occluded left anterior descending artery. Her recovery was complicated by low-grade pyrexia and raised inflammatory markers. Cardiovascular magnetic resonance 5 weeks after the acute presentation showed transmural infarction and global late gadolinium enhancement of the pericardium in keeping with Dressler's syndrome.

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          Cardiovascular magnetic resonance in pericardial diseases

          Jan Bogaert, Marco Francone (2009)
          The pericardium and pericardial diseases in particular have received, in contrast to other topics in the field of cardiology, relatively limited interest. Today, despite improved knowledge of pathophysiology of pericardial diseases and the availability of a wide spectrum of diagnostic tools, the diagnostic challenge remains. Not only the clinical presentation may be atypical, mimicking other cardiac, pulmonary or pleural diseases; in developed countries a shift for instance in the epidemiology of constrictive pericarditis has been noted. Accurate decision making is crucial taking into account the significant morbidity and mortality caused by complicated pericardial diseases, and the potential benefit of therapeutic interventions. Imaging herein has an important role, and cardiovascular magnetic resonance (CMR) is definitely one of the most versatile modalities to study the pericardium. It fuses excellent anatomic detail and tissue characterization with accurate evaluation of cardiac function and assessment of the haemodynamic consequences of pericardial constraint on cardiac filling. This review focuses on the current state of knowledge how CMR can be used to study the most common pericardial diseases.
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            Detection of pericardial inflammation with late-enhancement cardiac magnetic resonance imaging: initial results.

            John A M Taylor, Steven Dymarkowski, E Verbeken … (2006)
            To examine the value of late-enhancement cardiac magnetic resonance imaging (MRI) for detection of pericardial inflammation. Late-enhancement cardiac MRI was performed in 16 patients with clinical suspicion of pericardial disease. Pericardial effusion, pericardial thickening and pericardial enhancement were assessed. MRI findings were compared with those of definitive pericardial histology (n=14) or microbiology (n=2). A control group of 12 patients with no clinical evidence of pericardial disease were also imaged with the same MRI protocol. Sensitivity and specificity for late-enhancement MRI detection of pericardial inflammation was of 100%. There was MRI late enhancement of the pericardial layers in all five patients with histological/microbiological evidence of inflammatory pericarditis. MRI demonstrated no pericardial thickening and no MRI late enhancement with or without a pericardial effusion in any of the five patients with histological evidence of a normal pericardium. MRI detected pericardial thickening in the absence of both pericardial effusion and late enhancement in all six patients with histological evidence of chronic fibrosing pericarditis. The 12 control subjects showed no evidence of pericardial MRI late enhancement. These findings demonstrate that MRI late enhancement can be used to visualize pericardial inflammation in patients with clinical suspicion of pericardial disease.
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              Is Dressler syndrome dead?

              Karim Bendjelid, Jérome Pugin (2004)
              Post-acute myocardial infarction (AMI) syndrome was first described by Dressler in 1956. Its incidence has decreased in the reperfusion era, most likely because of the extensive use of thrombolysis and coronary balloon angioplasty, therapies that dramatically decreased the size of myocardial necrosis. The authors suggest that drugs that have been prescribed in previous decades as the post-AMI "standard-of-care," such as angiotensin-converting enzyme inhibitors, beta-blockers, and statins, may also play an important role in the disappearance of Dressler syndrome due to their immunomodulatory effects.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Cardiovasc Magn Reson
                Title: Journal of Cardiovascular Magnetic Resonance
                Publisher: BioMed Central
                ISSN (Print): 1097-6647
                ISSN (Electronic): 1532-429X
                Publication date Collection: 2009
                Publication date (Electronic): 23 July 2009
                Volume: 11
                Issue: 1
                Page: 23
                Affiliations
                [1 ]University Hospitals of Leicester, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK
                Article
                Publisher ID: 1532-429X-11-23
                DOI: 10.1186/1532-429X-11-23
                PMC ID: 2723097
                PubMed ID: 19627595
                SO-VID: eb5b1474-56a7-4b30-b6a3-a577af9c18ad
                Copyright © Copyright © 2009 Steadman et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 9 April 2009
                Date accepted : 23 July 2009
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Cardiovascular Medicine
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine

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