Definition

What is Dressler syndrome?

Dressler syndrome is a type of pericarditis, which is the inflammation of the sac around the heart (pericardium). It’s also called post-pericardiotomy syndrome, post-myocardial infarction syndrome, or post-cardiac injury syndrome. This is because the condition typically occurs after a heart surgery, myocardial infarction (heart attack), or injury. Dressler syndrome is thought to occur when the immune system responds excessively following one of these events.

If left untreated, inflammation of the pericardium can lead to scarring, thickening, and muscle tightening of the heart, which can be life-threatening.

How common is Dressler syndrome?

Fortunately, the condition is now considered very rare due to the development of modern treatments for heart attacks. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Dressler syndrome?

The common symptoms of Dressler syndrome are:

  • Chest pain that’s worse when lying down
  • Chest pain that worsens with deep breathing or coughing (pleuritic pain)
  • Fever
  • Difficult or labored breathing
  • Fatigue
  • Decreased appetite

Symptoms can occur two to five weeks after the initial event. In some people, symptoms may not develop for as long as three months.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Dressler syndrome?

Dressler’s syndrome is associated with an immune system response to heart damage. Your body reacts to the injured tissue by sending immune cells and proteins (antibodies) to clean up and repair the affected area. Sometimes this response causes excessive inflammation in the pericardium.

Post-pericardiotomy syndrome might affect 10 to 40 percent of people who have had heart surgery.

Risk factors

What increases my risk for Dressler syndrome?

There are many risk factors for Dressler syndrome, such as:

  • Heart surgery, such as open-heart surgery or coronary artery bypass surgery
  • Percutaneous coronary intervention, also known as coronary angioplasty and stent placement
  • Implantation of a pacemaker
  • Cardiac ablation
  • Pulmonary vein isolation
  • Penetrating trauma to the chest

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Dressler syndrome diagnosed?

Dressler syndrome is difficult to diagnose because its symptoms are similar to those of many other conditions. These include pneumonia, pulmonary embolism, angina, congestive heart failure (CHF), and heart attack.

A doctor may suspect you have Dressler syndrome if you start feeling ill a few weeks after a heart surgery or heart attack. They’ll want to conduct tests that help rule out other conditions and confirm a diagnosis.

Your doctor will first take a thorough medical history and perform a physical examination. They’ll listen to your heart with a stethoscope for sounds that might indicate the presence of inflammation or fluid near your heart.

Other tests may include:

  • Complete blood count (cbc)
  • Blood cultures to rule out infections
  • Echocardiogram to look for the presence of fluid near the heart or thickening in the pericardium
  • Electrocardiogram (ecg or ekg) to look for irregularities in your heart’s electrical impulses
  • Chest x-ray to see if there’s any inflammation in the lungs
  • Heart mri scan, which produces detailed images of the heart and the pericardium

How is Dressler syndrome treated?

The goals are to manage pain and reduce inflammation. Your doctor might recommend over-the-counter medications, such as:

  • Aspirin
  • Ibuprofen (Advil, Motrin IB, others)
  • Naproxen (Aleve)

If those medications don’t help, your doctor might prescribe:

  • 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.
  • 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.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Dressler syndrome?

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: May 22, 2018 | Last Modified: May 22, 2018

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