Dressler syndrome after minimally invasive coronary artery bypass surgery.

Dressler syndrome is a well-known complication of myocardial infarction and postsurgical instrumentation of the pericardium (as postpericardiotomy syndrome). Also called postmyocardial infarction syndrome, it typically occurs 3 weeks to several months after the surgery, with symptoms of fatigue, malaise, fever, chest pain, pleurisy, pneumonia, and left shoulder pain. Diagnostic evaluation may reveal an elevated sedimentation rate, leukocytosis, eosinophilia, pericarditis, and pleural effusions. Minimally invasive coronary artery bypass graft (CABG) surgeries avoid full midline sternotomy, aortic cannulation/manipulation, and use of cardiopulmonary bypass and achieve the same beneficial effect as traditional bypass surgeries with lower rates of complications. Although an English-language literature review from 1996 to 2003 revealed no reports of Dressler syndrome after minimally invasive CABG, the following case indicates that Dressler syndrome can occur after this procedure, probably because the pericardium is breached.