Ans. is 'a' i.e., Occurs within hours after myocardial infarction Post-cardiac injury syndrome (Dressler's syndrome} o The post-cardiac injury syndrome has also been called Dressler's syndrome, postpericardiotomy syndrome and when occurring after myocardial infarction (MI) post myocardial infarction syndrome. o It occurs in settings other than Ml particularly after cardiac surgery or pulmonary embolism, o PCIS was first described after MI by Dressler. o It is usually a late complication developing weeks to months after acute MJ. but rarely may be evident within the first week past MJ. Dressler's syndrome develops after an internal of l -4 weeks or even months following cardiac injury (MI) and not within hours. o The clinical manifestations include : # Pleuritic chest pain # Pericardial friction rub # Fever # Leucocytosis # Pleural effusion and pulmonary infiltrates o Thus both the time course and symptoms are different from early postinfarction pericarditis. Incidence o While generally considered to have occurred infrequently the incidence of PCIS is not clear. o Before the era of reperfusion, the incidence was believed to be 3% patients post-M.I. o PCIS following MI have largely disappeared in the reperfusion era due to a decrease in the size of most M.I. Pathogenesis o Immunological factors are thoughts to be of primary importance. o Pathogenesis begins with cardiac injury and that stimulates antibody formation. The immune complexes that are generated are deposited into the pericardium, pleura, and lungs. Diagnosis o Diagnosis is made by characteristic symptoms and increased ESR. Treatment o The pericarditis usually resolves in l -2 weeks with aspirin. NSAIDs or analgesic (often no treatment is necessary). o Therapy with corticosteroids is sometimes required in resistant cases.