About Dressler's Syndrome

Dressler's syndrome is thought to result from damage to the heart tissue following heart surgery or a heart attack. It occurs when the individual's body sends antibodies to the damaged area. This response is normal; however, in some people it causes too much inflammation in the pericardium, the sac that surrounds the heart. This syndrome is also called postmyocardial infarction syndrome.

Symptoms

The symptoms of Dressler's syndrome may occur weeks or even months following a cardiac incident. They can include a fatigued achy feeling, fever, chest pain, and fever. Any of these symptoms in a heart patient should prompt seeking medical care as soon as possible.

There are dangerous complications possible from Dressler's syndrome. If too much fluid builds in the pericardium, the heart becomes overworked trying to pump more blood. The pressure makes the heart's job much more difficult. The resulting condition is called cardiac tamponade.

Similarly, if the pericardium becomes too scarred and thick, the heart is forced to work beyond its capability, causing a condition called constrictive pericarditis.

These complications can be quite critical and require invasive treatment. Therefore, it is important that the symptoms of Dressler's syndrome be addressed as soon as possible.

Treatment

The goals of treatment in cases of Dressler's syndrome are to reduce the pericardial inflammation and manage pain. Anti inflammatory medication will be given, usually naproxen, aspirin or ibuprofen depending on the patient. If these are not effective, stronger drugs such as corticosteroids or colchicine may be tried. Since corticosteroids or colchicine involve more possible adverse side effects, they are rarely chosen as the first course of treatment.

When complications do arise, invasive methods must be used. In some cases of constrictive pericarditis, the entire pericardium may be removed. The heart can function normally without the pericardium, but it is not the first course of treatment of inflammation since the surgery always carries risk.

In the case of cardiac tamponade, excess fluid must be drained from around the heart. A procedure called pericardiocentesis will be done using a tube or needle to drain the fluid. The patient is given local anesthesia in order to withstand this procedure.

There are other conditions which can occur following any type of hospitalization or surgery, including conditions involving the lung, which can cause similar symptoms to Dressler's syndrome. It is wise for anyone who experiences chest pain for more than a few minutes should seek medical attention.

Sources:

Mayo Clinic

Signet/Mosby Medical Encyclopedia

National Institute of Health