A 55-year-old man develops pleuritic chest pain and fever 3 weeks after an acute myocardial infarction. ECG shows diffuse ST elevation. Pericardial friction rub is present. What is the most likely diagnosis?
- A Dressler syndrome ✓
- B Early post-infarction pericarditis
- C Recurrent myocardial infarction
- D Pulmonary embolism
Correct answer: A. Dressler syndrome
Explanation
Dressler syndrome is an autoimmune pericarditis occurring 2 to 12 weeks after MI, caused by antibodies formed against damaged cardiac tissue. It presents with pleuritic chest pain, fever, pericardial friction rub, and diffuse ST elevation. Early post-infarction pericarditis occurs within 1 to 3 days of MI and is a direct inflammatory response to transmural necrosis, not autoimmune. Recurrent MI would show localized ST changes and troponin rise. PE causes pleuritic pain but not pericardial rub or diffuse ST elevation.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.