Description

Dressler syndrome is the swelling and irritation in the sac around the heart that occurs after damage to the heart muscle. The damage can trigger an immune system response that causes the condition. The damage can be the result of a heart attack, heart surgery or a serious injury.

The symptoms of Dressler syndrome include chest pain that may feel chest pain of a heart attack.

The swelling and irritation of the sac around the heart is called pericarditis. Dressler syndrome is a type of pericarditis that can begin after the heart muscle is damaged. So you can listen Dressler syndrome called post-traumatic pericarditis.

Some other names for the condition are:

  • Post-myocardial infarction syndrome.
  • Post-cardiac injury syndrome.
  • Post-pericardiotomy syndrome.

Symptoms

The symptoms of Dressler syndrome is likely to start from a few weeks to a few months after a heart attack, surgery, or an injury to the chest. Symptoms may include:

  • Pain in the chest, which may get worse with deep breaths.
  • Fever.
  • Shortness of breath.

When to see a doctor

Receive emergency care for sudden or ongoing pain in the chest. This can be a symptom of a heart attack or another serious illness.

Causes

Experts believe Dressler syndrome is caused by the immune system's response to damage in the heart. The body reacts to the injured tissue by sending immune cells and proteins called antibodies to clean and repair the affected area. Sometimes this response causes swelling due to inflammation of the sac around the heart is known as pericardium.

Dressler syndrome can happen after a heart attack or any heart surgeries or procedures. It can also occur after a severe injury in the chest, such as the trauma of a car accident.

Risk factors

The damage to the heart muscle, increases the risk of Dressler syndrome. Some of the things that cause the heart muscle are:

  • Chest injury.
  • Some types of heart surgery.
  • Heart attack.

Complications

A complication of Dressler syndrome is the accumulation of fluid in the tissues surrounding the lungs is called pleural effusion.

Rarely, Dressler syndrome can cause more serious complications, including:

  • Cardiac tamponade. Inflammation of the pericardium can cause accumulation of fluid in the sac. The fluid can put pressure on the heart. The pressure forces the heart to work harder, and the heart does not pump blood as well as it should.
  • Constrictive pericarditis. The inflammation going on, or keeps coming back can cause the pericardium to become thick, or with scars. The scarring can reduce the heart's ability to pump blood.

Prevention

Some studies suggest that taking anti-inflammatory medication colchicine (Colcrys, Gloperba, others) soon after cardiac surgery can help prevent the Dressler syndrome.

Diagnosis

The diagnosis of Dressler syndrome begins with a physical examination of your health care professional. The exam includes listening to the heart with a device called a stethoscope. A sound called a pericardial friction rub can happen when the pericardium becomes inflamed or when the liquid has been collected around the heart.

Tests that can help find out if you have Dressler syndrome include:

  • Complete blood count. The majority of people with Dressler syndrome have an increased white blood cell count.
  • Blood tests to measure inflammation. A blood test can check the level of C-reactive protein produced by the liver. A higher level of this protein may be a sign of inflammation which is linked with Dressler syndrome. Another blood test called the erythrocyte sedimentation rate measures how fast red blood cells sink to the bottom of a test tube. When you are sinking fast, it can be a sign of more inflammation.
  • Electrocardiogram (ECG or EKG). This quick test checks the electrical activity of the heart. It is shown how the heart is beating. Sticky patches called electrodes attached to the chest and sometimes the arms and legs. The wires connect the electrodes to a computer that prints or displays the results of the test. Certain changes in the electrical signals of the heart can be a sign of pressure on the heart. But these changes may occur after cardiac surgery, for which the results of other studies are necessary to confirm if you have Dressler syndrome.
  • X-ray of the chest. A chest x-ray can help to detect fluid around the heart or lungs. It can also help you find out if the fluid is caused by a different condition, such as pneumonia.
  • The echocardiogram. The sound waves create an image of the heart to show whether the fluid is gathering around them.
  • Cardiac magnetic resonance. This test uses sound waves to create images, still or moving, of how blood flows through the heart. This test may show thickening of the pericardium.

Treatment

The goals of treatment for the Dressler syndrome are to control pain and reduce inflammation. The treatment may include medication. Surgery may be required if complications occur.

Drugs

The main treatment for the Dressler syndrome is a medicine to lower inflammation, including nonsteroidal anti-inflammatory drugs (Nsaids), such as:

  • The aspirin.
  • Ibuprofen (Advil, Motrin IB, others).
  • Colchicine (Colcrys, Gloperba, other).

If the Dressler syndrome that occurs after a heart attack, usually aspirin is preferable to other Nsaids.

Indomethacin may also be given.

If medications don't help, the next step might be to corticosteroids. These can reduce the inflammation linked with Dressler syndrome by turning off the immune system.

Corticosteroids can have serious side effects. And that could interfere with the healing of the damaged heart tissue after a heart attack or surgery. For these reasons, corticosteroids tend to be used only when other treatments do not work.

Surgery or other procedures

Other treatments may be necessary to treat the complications of Dressler syndrome. These include:

  • Drain the excess liquid. For cardiac tamponade, the excess fluid can be removed with a needle or a small tube called a catheter. This treatment is called pericardiocentesis. Usually makes use of medicine called a local anesthetic that numbs a specific part of the body.
  • Removal of the pericardium. For constrictive pericarditis, treatment may include surgery to remove the pericardium. The surgery is called a pericardiectomy.

Preparing for your appointment

If you are being seen in the emergency room for chest pain, you may ask:

  • When did your symptoms begin?
  • How bad is the chest pain on a scale of 1 to 10?
  • Does anything make your symptoms worse? For example, does it hurt more when you take a deep breath?
  • Where is the pain? Do you go anywhere beyond your chest?
  • You have recently had a heart attack, heart surgery or blunt trauma to the chest?
  • Do you have a history of heart disease?
  • What medications do you take?
Symptoms and treatment of Dressler syndrome