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What is Dressler's Syndrome?

Published in Cardiology 3 mins read

Dressler's syndrome is a type of pericarditis, which is the inflammation of the pericardium—the sac-like membrane surrounding the heart. It typically occurs as a delayed reaction after damage to the heart tissue, often stemming from a heart attack, surgery, or injury.

Understanding Dressler's Syndrome

Dressler's syndrome is believed to be an autoimmune response where the body's immune system mistakenly attacks the healthy tissue of the pericardium following heart damage. This inflammation can lead to a variety of symptoms and complications.

Causes

While the exact cause is not fully understood, potential triggers for Dressler's syndrome include:

  • Myocardial Infarction (Heart Attack): Damage to heart tissue during a heart attack can trigger the syndrome.
  • Cardiac Surgery: Procedures like bypass surgery or valve replacement can sometimes lead to this condition.
  • Trauma: Injury to the chest or heart can also be a cause.
  • Other Medical Conditions: In rare cases, certain infections or autoimmune disorders may be associated with Dressler's syndrome.

Symptoms

Symptoms of Dressler's syndrome can vary, but common ones include:

  • Chest Pain: Often sharp and stabbing, worsening with breathing or lying down.
  • Fever: A mild to moderate increase in body temperature.
  • Pericardial Friction Rub: A grating sound heard with a stethoscope as the inflamed pericardium rubs against the heart.
  • Shortness of Breath: Difficulty breathing, particularly when lying down.
  • Fatigue: Feeling unusually tired or weak.

Diagnosis

Diagnosing Dressler's syndrome typically involves:

  • Physical Exam: Listening for a pericardial friction rub and assessing other symptoms.
  • Electrocardiogram (ECG): To detect abnormalities in heart rhythm or electrical activity.
  • Echocardiogram: An ultrasound of the heart to visualize the pericardium and detect fluid buildup (pericardial effusion).
  • Blood Tests: To check for inflammation markers, such as elevated white blood cell count and inflammatory markers (CRP, ESR).
  • Chest X-ray: Can reveal enlargement of the heart or fluid around it.

Treatment

Treatment for Dressler's syndrome typically focuses on reducing inflammation and managing symptoms. Options include:

  • Anti-inflammatory Medications:
    • NSAIDs (Nonsteroidal Anti-inflammatory Drugs): Such as ibuprofen or aspirin, to reduce pain and inflammation.
    • Colchicine: An anti-inflammatory drug often used in conjunction with NSAIDs.
  • Corticosteroids: Prednisone, may be used if NSAIDs and colchicine are ineffective or contraindicated, but are typically avoided due to potential side effects.
  • Pericardiocentesis: In rare cases, if there is significant fluid buildup around the heart (pericardial effusion) causing compression (cardiac tamponade), a procedure to drain the fluid may be necessary.

Outlook

With appropriate treatment, most individuals with Dressler's syndrome recover fully. However, recurrent episodes can occur in some cases. Following medical advice and maintaining regular follow-up appointments are crucial for managing the condition effectively.