Dressler syndrome (post-MI pericarditis) typically presents how many weeks after myocardial infarction, and which is the MOST appropriate first-line treatment?

• A 3–7 days; high-dose aspirin
• B 6–12 weeks; corticosteroids
• C Immediately at reperfusion; NSAIDs
• D 1–6 weeks; aspirin and colchicine ✓

Explanation

Dressler syndrome (post-cardiac injury syndrome) is an autoimmune pericarditis occurring 1–6 weeks after MI. It is mediated by antibodies against cardiac antigens released during myocardial necrosis. First-line treatment is aspirin plus colchicine (as per ICAP/COPE trial evidence). NSAIDs and corticosteroids are relatively contraindicated in the early post-MI period due to impaired scar formation and increased risk of re-infarction. Early-onset pericarditis (3–7 days) is usually infarction pericarditis, not Dressler.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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