Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever, pleuritic pain, pericarditis and/or a pericardial effusion. Dressler syndrome is also known as postmyocardial infarction syndrome and the term is sometimes used to refer to post-pericardiotomy pericarditis. Dressler's syndrome is a type of pericarditis in which inflammation of the sac surrounding the heart (pericardium). Dressler's syndrome is believed to be an immune system response after damage to heart tissue or to the pericardium, from events such as a heart attack, surgery or traumatic injury. Symptoms include chest pain, which may be similar to chest pain experienced during a heart attack. Dressler's syndrome may also be called postpericardiotomy syndrome, post-myocardial infarction syndrome and post-cardiac injury syndrome. With recent improvements in heart attack treatment, Dressler's syndrome is less common than it used to be. It is believed to result from an autoimmune inflammatory reaction to myocardial neo-antigens formed as a result of the MI. A similar pericarditis can be associated with any pericardiotomy or trauma to the pericardium or heart surgery. Dressler syndrome needs to be differentiated from pulmonary embolism, another identifiable cause of pleuritic (and non-pleuritic) chest pain in people who have been hospitalized and/or undergone surgical procedures within the preceding weeks. Symptoms are likely to appear weeks to months after a heart attack, surgery or injury to the chest. Symptoms might include: i. Chest pain ii. ii. Fever.
Dressler syndrome occurs in about 7% of myocardial infarctions, and consists of a persistent low-grade fever, chest pain (usually pleuritic in nature), pericarditis (usually evidenced by a pericardial friction rub), and/or a pericardial effusion. The symptoms tend to occur 2–3 weeks after myocardial infarction, but can also be delayed for a few months. It tends to subside in a few days, and very rarely leads to pericardial tamponade. An elevated ESR is an objective laboratory finding. It was first characterized by William Dressler at Maimonides Medical Center in 1956. It should not be confused with the Dressler's syndrome of haemoglobinuria named for Lucas Dressler, who characterized it in 1854.
The goals are to manage pain and reduce inflammation. Your doctor might recommend medicines, such as: Aspirin, Ibuprofen (Advil, Motrin IB, others), Naproxen (Aleve) If those medications don't help, your doctor might prescribe: Colchicine: This anti-inflammatory medication might be used, along with over-the-counter medications, to treat Dressler's syndrome. Some studies suggest that colchicine taken before cardiac surgery might help prevent postpericardiotomy. The effectiveness of colchicine for treating existing post-cardiac injury syndrome isn't clear. Corticosteroids: These immune-system suppressants can reduce inflammation related to Dressler's syndrome. Corticosteroids can have serious side effects and might interfere with the healing of damaged heart tissue after a heart attack or surgery. For those reasons, corticosteroids are generally used only when other treatments don't work. Treating complications Complications of Dressler's syndrome can require more-invasive treatments, including: Draining excess fluids: If you develop cardiac tamponade, your doctor will likely recommend a procedure (pericardiocentesis) in which a needle or small tube (catheter) is used to remove the excess fluid. The procedure is usually done using a local anesthetic. Removing the pericardium: If you develop constrictive pericarditis, you might need surgery to remove the pericardium (pericardiectomy). Some research indicates that younger people and people who have symptoms of constrictive pericarditis soon after surgery are more likely to need invasive treatments for complications of Dressler's syndrome.