Post-AMI pericarditis occurs in 10 to 20 percent of patients. It is more common in patients with transmural AMI. It results from inflammation adjacent to the pericardium on the epicardial surface of a transmural infarction. It generally occurs 2 to 4 days after AMI. Pericardial friction rubs are more often detected with inferior wall and right ventricular infarction because the right ventricle lies immediately beneath the chest wall. The pain of pericarditis can be confused with that of infarct extension or post-AMI angina. Classically the discomfort of pericarditis becomes worse with a deep inspiration and may be somewhat relieved by sitting forward. Echocardiography may demonstrate a pericardial effusion, but pericardial effusions are much more common than pericarditis and are often present in the absence of pericarditis.
Similarly, pericarditis can be present in the absence of a pericardial effusion. The resorption rate of post-AMI pericardial effusions are slow, often taking several months. Dressler syndrome (post-AMI syndrome) occurs 2 to 10 weeks after AMI and presents as chest pain, fever, and pleuropericarditis.
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