Learn about the symptoms and treatment of inflammation of the sac surrounding the heart in post-cardiac injury syndromes.
Dressler syndrome is a type of inflammation of the sac surrounding the heart (pericarditis). Dressler syndrome is believed to be an immune system response after damage to heart tissue or to the sac surrounding the heart (pericardium). Such damage may occur from events such as a heart attack, surgery or traumatic injury. Symptoms include chest pain, which may be similar to chest pain experienced during a heart attack.
Dressler syndrome may also be called post-myocardial infarction syndrome, post-traumatic pericarditis, post-cardiac injury syndrome and post-pericardiotomy syndrome.
Symptoms are likely to appear weeks to months after a heart attack, surgery or injury to the chest. Symptoms might include:
Seek emergency care for sudden or persistent chest pain, which may signal a heart attack or other serious disorder.
Experts think Dressler syndrome is caused by the immune system's 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.
Dressler syndrome may occur after certain heart surgeries or procedures.
The immune system reaction that causes Dressler syndrome might also lead to fluid buildup in the tissues surrounding your lungs (pleural effusion).
Rarely, Dressler syndrome can cause more-serious complications, including:
Some preliminary studies suggest that taking the anti-inflammatory medication colchicine before heart surgery might help prevent Dressler syndrome.
Your doctor will do a thorough physical examination, including listening to your heart with a stethoscope. A specific sound, called a pericardial rub, can occur when your pericardium is inflamed or when fluid has collected around your heart.
Your doctor might then recommend tests, such as:
The goals of treatment for Dressler syndrome are to manage pain and reduce inflammation. Treatment may involve medications and, if complications occur, surgery.
The main treatment for Dressler syndrome is medication to reduce inflammation. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) such as:
If Dressler syndrome occurs after a heart attack, usually aspirin is preferred over other NSAIDs.
Indomethacin may also be given.
If those medications don't help, your doctor might prescribe corticosteroids. These powerful immune system suppressants can reduce inflammation related to Dressler 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.
Complications of Dressler syndrome can require more-invasive treatments, including:
If you're being seen in the emergency room for chest pain, you might be asked:
October 28th, 2021