A 76-year-old woman with idiopathic dilated cardiomyopathy and left bundle branch block was admitted for biventricular pacemaker implantation. The procedure was complicated by perforation of a coronary sinus tributary vein and ensuing pericardial effusion without tamponade. Three months later, she presented with fever, pleuritic chest pain and functional class worsening. Pericardial and pleural effusions were noted. Sterile blood and pleural fluid cultures and failure to respond to antibiotic therapy led to the hypothesis of a Dressler-like syndrome. The patient improved clinically with a short course of steroid therapy and was discharged on colchicine. A chest X-ray performed after 2 months showed a complete remission of pleural effusion.
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