PT  - JOURNAL ARTICLE
AU  - Beni R Verma
AU  - Michael Chetrit
AU  - James L Gentry III
AU  - Andrew Noll
AU  - Ahmed Bafadel
AU  - Mohamed Khayata
AU  - Serge C Harb
AU  - Bo Xu
AU  - Apostolos Kontzias
AU  - Deborah H Kwon
AU  - Christine Jellis
AU  - Allan L Klein
TI  - Multimodality imaging in patients with post-cardiac injury syndrome
AID  - 10.1136/heartjnl-2019-316050
DP  - 2020 May 01
TA  - Heart
PG  - 639--646
VI  - 106
IP  - 9
4099  - http://heart.bmj.com/content/106/9/639.short
4100  - http://heart.bmj.com/content/106/9/639.full
SO  - Heart2020 May 01; 106
AB  - This review article is focused on the role of echocardiography, cardiac CT and cardiac magnetic resonance (CMR) imaging in diagnosing and managing patients with post-cardiac injury syndrome (PCIS). Clinically, the spectrum of pericardial diseases under PCIS varies not only in form and severity of presentation but also in the timing varying from weeks to months, thus making it difficult to diagnose. Pericarditis developing after recent or remote myocardial infarction, cardiac surgery or ablation if left untreated or under-treated could worsen into complicated pericarditis which can lead to decreased quality of life and increased morbidity. Colchicine in combination with other anti-inflammatory agents (non-steroidal anti-inflammatory drugs) is proven to prevent and treat acute pericarditis as well as its relapses under various scenarios. Imaging modalities such as echocardiography, CT and CMR play a pivotal role in diagnosing PCIS especially in difficult cases or when clinical suspicion is low. Echocardiography is the tool of choice for emergent bedside evaluation for cardiac tamponade and to electively study the haemodynamics impact of constrictive pericarditis. CT can provide information on pericardial thickening, calcification, effusions and lead perforations. CMR can provide pericardial tissue characterisation, haemodynamics changes and guide long-term treatment course with anti-inflammatory agents. It is important to be familiar with the indications as well as findings from these multimodality imaging tools for clinical decision-making.