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Case of the Week 464



What is the most likely diagnosis?

  • 68 year-old with fever and chest pain



Frontal Chest Radiographs at Time of Surgery and Three Weeks Later

  1. Pulmonary Embolism
  2. Tuberculosis
  3. Rheumatoid Arthritis
  4. Postpericardiotomy Syndrome
  5. Pneumonia

Additional Image - None

 

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Answer:

 

4. Postpericardiotomy Syndrome

 

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Postpericardiotomy Syndrome

General Considerations

  • Autoimmune and febrile illness that can follow coronary artery bypass surgery
  • May also be seen following myocardial infarction (Dressler’s syndrome)
  • Reported to occur in 10-40% of cases
  • Combination of pericarditis, pleuritis and pneumonitis
  • Believed to have immunologic cause
  • Possibly a latent viral infection may be cause

 

MORE . . .

 


.

This Week
68 year-old with fever and chest pain
 
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Some of the fundamentals of interpreting chest images
 
The top diagnostic imaging diagnoses that all medical students should recognize according to the Alliance of Medical Student Educators in Radiology
 
Recognizing normal and  key abnormal intestinal gas patterns, free air and abdominal calcifications
 
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LearningRadiology.com
is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.