Acute Pericarditis after Percutaneous Coronary Intervention: A Case Report

Abstract

Background: Percutaneous coronary intervention (PCI) is known as a very rare possible trigger of pericarditis. Most frequently it develops after a latent period or early in the case of periprocedural complications. In this report, we present an atypical early onset of pericarditis after an uncomplicated PCI. Case Summary: A 58-year-old man was admitted to the hospital for PCI of the chronic total occlusion of the left anterior descending (LAD) artery. An initial electrocardiogram (ECG) was unremarkable. The PCI attempt was unsuccessful. There were no procedure-related complications observed at the end of the PCI attempt and the patient was symptom free. Six hours after the interventional procedure, the patient complained of severe chest pain. The ECG demonstrated ST-segment elevation in anterior and lateral leads. Troponin I was mildly elevated but a coronary angiogram did not reveal the impairment of collateral blood flow to the LAD territory. Due to pericarditic chest pain, typical ECG findings and pericardial effusion with elevated C-reactive protein, the diagnosis of acute pericarditis was established, and a course of nonsteroidal anti-inflammatory drugs (NSAIDs) was initiated. Chest pain was relieved and ST-segment elevation almost completely returned to baseline after three days of treatment. The patient was discharged in stable condition without chest pain on the fourth day after symptom onset. Conclusions: Acute pericarditis is a rare complication of PCI. Despite the lack of specific clinical manifestation, post-traumatic pericarditis should be considered in patients with symptoms and signs of pericarditis and a prior history of iatrogenic injury or thoracic trauma.

Post Percutaneous Coronary Intervention Pericarditis and Positive Effect of Colchicine on Patient Condition

“…Post cardiac injury syndrome (PCIS), also known as post pericardiectomy syndrome and Dressler's syndrome, commonly occurs after cardiac surgery or following myocardial infarction, but has also been reported following temporary/permanent pacemaker implantation and radiofrequency ablation, and, as reported here and by others, can be a rare complication following PCI [8]. The chances of developing pericarditis are approximately 0.2% post coronary angiography [9]. Sometimes invasive cardiac procedures may lead to epicardia myocardial and pericardial damage that may lead to accumulation of debris and blood in the pericardium.…”