Recurrent pericarditis in the structure of post-cardiac injury syndrome: clinical case report

Aim. To demonstrate features of the clinical course and therapy of recurrent pericarditis after percutaneous coronary intervention as a type of post-cardiac injury syndrome.

Material and methods. Patient Sh., 76 years old, with coronary artery disease, developed exudative fibrinous pericarditis with subsequent recurrence after elective percutaneous coronary intervention with an attempted recanalization of a chronic total occlusion of the right coronary artery. Comprehensive laboratory and instrumental diagnostics were performed, and therapy with nonsteroidal anti-inflammatory drugs in combination with colchicine was initiated, followed by an assessment of the effectiveness of the administered therapy.

Results. Against the background of combined anti-inflammatory therapy with ibuprofen 800 mg three times daily and colchicine 0.5 mg twice daily for 4 months, a sustained clinical and laboratory effect was achieved, including clinical improvement, normalization of C-reactive protein levels, and regression of pericarditis manifestations according to echocardiographic data.

Conclusion. This case highlights that post-interventional pericarditis may occur even after elective percutaneous coronary intervention without overt mechanical complications and may become recurrent. Early recognition of post-cardiac injury syndrome, differential diagnosis with other conditions, and the use of prolonged colchicine-containing anti-inflammatory therapy are required.