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Dressler's Syndrome

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  • Dressler's syndrome

    Dressler's syndrome is a type of pericarditis 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. Also called postmyocardial infarction syndrome, it typically occurs 3 weeks to several months after the surgery. Dressler’s syndrome was first described in 1956. It is characterised by pleuritic chest pain, low-grade fever and pericarditis (autopsy shows localised fibrinous pericarditis), which may be accompanied by pericardial effusion. It tends to follow a benign clinical course. It is thought to be immune-mediated.

  • Dressler's syndrome

    The symptoms for Dressler's syndrome are as follows:

    Pleuritic pain may be associated with pleurisy and pleural effusion.

    • Significant pericardial effusion can cause cardiac tamponade.

    • Inflammation can result in constrictive pericarditis.

    • 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. The pain may initially suggest a further episode of angina or myocardial infarction. Pleuritic chest pain may also suggest pneumonia or pulmonary embolism. The different diagnosis that are performed are as follows:

    Echocardiogram: Sound waves produce an image of your heart, helping your doctor to see if fluid is collecting around it.

    Electrocardiogram: Electrical impulses in your heart are recorded through wires attached to your skin. Certain changes in the electrical impulses can indicate pressure on your heart. But electrocardiogram readings may be abnormal after heart surgery, so your doctor likely won't rely on this one test for a diagnosis of Dressler's syndrome.

    Blood tests: The results of certain tests can indicate inflammatory activity that's consistent with Dressler's syndrome.

  • Dressler's syndrome

    Generally the drugs are administered to reduce pain and inflammation such as aspirin,Ibuprofen,Naproxen, Colchichine and some corticosteroids are also used.

    The original paper by Dressler in 1956 suggested an incidence of 3-4% of all cases of acute myocardial infarction. It is now much rarer, probably due to modern methods of management of an acute myocardial infarction. If a person has had a previous episode, it is more likely to recur. It seems more likely to occur after a large infarct. Estimated frequencies vary from 2-30% of patients undergoing surgery that involves opening of the pericardium.Postpericardiotomy syndrome is uncommon in infants, but the frequency increases in children and adults to as much as 30%.

 

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