FDG PET/CT in Dressler Syndrome

Nuclear imaging has paramount role in the evaluation of 4I (infective, inflammatory, innervation, infiltrative) cardiac diseases. We present a case of persistent pyrexia post-percutaneous transluminal coronary angioplasty with a history of inferior wall myocardial infarction 2 months back. Repeat coronary angiogram revealed that Right Coronary Artery (RCA) thrombus and IV antibiotics were started in suspicion of coronary stent infection. F-18-FDG PET/CT revealed no hypermetabolism along RCA stent, with uptake along pericardium and inferior wall. Tc-99m-MIBI myocardial perfusion study showed perfusion defect in RCA territory corresponding to hibernating viable myocardium. Eventually patient was diagnosed with Dressler syndrome. Thus, molecular imaging helped in narrowing differentials in post cardiac intervention pyrexia and precise diagnosis.

Automated summary

Nuclear imaging plays a crucial role in evaluating cardiac diseases of infective, inflammatory, innervation, and infiltrative origins. We report a case of persistent pyrexia after percutaneous transluminal coronary angioplasty in a patient with a history of inferior wall myocardial infarction. Molecular imaging techniques, such as F-18-FDG PET/CT and Tc-99m-MIBI myocardial perfusion study, helped in narrowing the differentials and eventually diagnosing the patient with Dressler syndrome.