Dressler syndrome

Dressler syndrome, also known as postmyocardial infarction syndrome, is a form of pericarditis — inflammation of the pericardium, the protective sac surrounding the heart. This condition typically occurs in the aftermath of a heart attack, heart surgery, or following a chest injury. Dressler syndrome is considered an immune system response to heart damage.

Causes and Pathophysiology

The exact cause of Dressler syndrome is not fully understood, but it is believed to be an autoimmune response. After heart tissue is damaged, the body may mistakenly attack its own cells during the healing process. This autoimmune response leads to inflammation of the pericardium. Dressler syndrome typically manifests weeks to months after the initial heart damage, distinguishing it from acute pericarditis that may occur more immediately following a heart event.

Symptoms

Common symptoms of Dressler syndrome include:

• Chest pain that may feel sharp and worsen with deep breathing or lying down
• Fever
• Fatigue
• Shortness of breath
• A pericardial friction rub — a grating sound heard with a stethoscope that occurs with the movement of the inflamed pericardial layers

Diagnosis

Diagnosis of Dressler syndrome involves a combination of clinical evaluation, medical history, and diagnostic tests. These may include:

• Echocardiogram: An ultrasound of the heart to visualize the pericardium and check for fluid accumulation.
• Electrocardiogram (ECG or EKG): To detect abnormalities in the heart's electrical activity that may indicate pericarditis.
• Blood tests: To look for markers of inflammation and possible cardiac damage.
• Chest X-ray: To examine the size and shape of the heart and rule out other conditions.

Treatment

Treatment for Dressler syndrome aims to relieve symptoms and reduce inflammation. Common treatment options include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): To reduce inflammation and pain.
• Colchicine: An anti-inflammatory medication that may be used alone or in combination with NSAIDs to treat pericarditis.
• Corticosteroids: In severe cases, when symptoms are not responsive to NSAIDs or colchicine.
• Pericardiocentesis: A procedure to remove excess fluid from the pericardial sac if it is causing significant symptoms or cardiac tamponade.

Prognosis

With appropriate treatment, the prognosis for Dressler syndrome is generally good. Most individuals recover fully, though the condition can recur. Monitoring and follow-up care are important to manage symptoms and prevent complications.

Prevention

There is no definitive way to prevent Dressler syndrome, but early treatment of heart injuries and close monitoring after heart surgery or a heart attack may reduce the risk of developing the condition.