امرأة عمرها ٦٢ سنة بعد احتشاء بثلاثة أسابيع رجعت بحمى ٣٨٫٢ وألم صدري حاد يزيد مع النفس ويخف عند الجلوس للأمام. يُسمع احتكاك تاموري، والتخطيط بدون علامات احتشاء جديد، وفي التحاليل ارتفاع ESR. ما التشخيص الأرجح وما العلاج المتوقع؟

A 62-year-old woman returns three weeks after an MI with fever 38.2 °C and sharp chest pain worse on breathing and eased by leaning forward. A pericardial rub is heard, the ECG shows no new infarction and ESR is raised. What is the likely diagnosis and expected treatment?

1. A pulmonary embolism, treated with thrombolysis
2. A new MI, treated with urgent catheterisation
3. Dressler syndrome, treated with aspirin or colchicine
4. A catheter-site wound infection, treated with two weeks of IV antibiotics

Answer: C) Dressler syndrome, treated with aspirin or colchicine. Dressler syndrome is an immune pericarditis weeks after MI, with fever, pericardial pain and raised inflammatory markers. It is usually treated with aspirin or colchicine, and other NSAIDs are avoided after a recent MI.