A 65-year-old female presents with chest pain, fever, and shortness of breath 2 weeks after an MI. What condition does she most likely have?

The presentation of a 65-year-old female with chest pain, fever, and shortness of breath two weeks after a myocardial infarction (MI) is highly suggestive of Dressler's syndrome. This condition is classified as a type of post-myocardial infarction syndrome, characterized by an autoimmune reaction to myocardial antigens following heart injury. This immune response typically manifests several weeks after the initial insult, which aligns with the timing observed in this patient, showing symptoms 2 weeks post-MI.

Dressler's syndrome commonly involves symptoms of pleuritic chest pain, fever, and signs of pericarditis, indicating inflammation of the pericardium. The presentation of fever is particularly notable, as it often distinguishes Dressler's syndrome from other post-MI complications.

In contrast, while congestive heart failure can occur after an MI, it generally presents with different symptoms, such as persistent shortness of breath due to fluid overload, rather than the combination of chest pain and fever. A new myocardial infarction could theoretically occur but would likely present with more acute and severe symptoms shortly after the event. Lastly, pneumonia could cause fever and shortness of breath, but the timing following the MI and the specific symptoms are more characteristic of Dressler