Post-Myocardial Infarction Syndrome Symptoms and Clinical Manifestations

Post-myocardial infarction syndrome, also known as Dressler's syndrome, typically presents 2 to 4 weeks following an acute cardiac injury. Common symptoms include fever, fatigue, and chest pain, which may be accompanied by additional signs such as peripheral edema, dyspnea, and reduced appetite. These clinical features often point to an underlying inflammatory process.

Physical Examination Findings

During a physical exam, signs of pericarditis and pleuritis may be observed. These can include pericardial friction rub, pleural friction rub, and chest discomfort. Additionally, the presence of pericardial or pleural effusion may be detected, further supporting the diagnosis.

Laboratory and Diagnostic Features

Laboratory tests often reveal elevated white blood cell counts and an increased erythrocyte sedimentation rate (ESR), both of which are indicative of systemic inflammation. These markers help support the clinical suspicion of post-MI syndrome.

Electrocardiogram (ECG) Changes

The electrocardiogram typically lacks specific diagnostic features. However, in some cases, ST-segment elevation in lead aVR may be observed. When significant pericardial effusion is present, findings such as electrical alternans and low QRS voltage may also appear on the ECG.

Imaging Studies

Chest X-ray findings may show an enlarged cardiac silhouette, signs of pulmonary infiltrates, and pleural effusion. These imaging features are consistent with the presence of pericardial and pleural involvement.

Echocardiographic Findings

Echocardiography may reveal pericardial effusion, impaired left ventricular function, and abnormal wall motion. These findings are important in assessing the extent of cardiac involvement and guiding further management.