Dressler's syndrome

Dressler's syndrome is a form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart).

Dressler's syndrome is also known as postmyocardial infarction syndrome and postcardiotomy pericarditis.

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Presentation

The syndrome consists of a persistent low-grade fever, chest pain (usually pleuritic in nature), a pericardial friction rub, and /or a pericardial effusion. The symptoms tend to occur after a few weeks or even months after infarction and tend to subside in a few days. An elevated ESR is an objective laboratory finding.

Causes

It is believed to result from an autoimmune inflammatory reaction to myocardial neo-antigens.

Dressler's syndrome is associated with myocardial infarction (heart attack), and with heart surgery.

Differential diagnosis

In the setting of myocardial infarction, Dressler's syndrome occurs in about 7% of cases,^[1] and typically occurs 2 to 10 weeks after the myocardial infarction occurred. This differentiates Dressler's syndrome from the much more common post myocardial infarction pericarditis that occurs in 17 to 25% of cases of acute myocardial infarction and occurs between days 2 and 4 after the infarction. Dressler's syndrome also 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.

Treatment

Dressler's syndrome is typically treated with NSAIDs such as aspirin or with corticosteroids.^[2]

See also

References

1. ^ Krainin F, Flessas A, Spodick D (1984). "Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram.". N Engl J Med 311 (19): 1211-4. PMID 6493274.
2. ^ Gregoratos G (1990). "Pericardial involvement in acute myocardial infarction.". Cardiol Clin 8 (4): 601-8. PMID 2249214.

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