What are the other Names for this Condition? (Also known as/Synonyms)

• Post-Myocardial Infarction Syndrome
• Post Pericardiotomy Pericarditis

What is Dressler Syndrome? (Definition/Background Information)

• Dressler Syndrome can be described as a form of pericarditis that normally develops following a heart attack, which results in injury to the heart or pericardium. Due to this, it is also referred to as Post-Myocardial Infarction Syndrome
• Pericarditis refers to swelling and inflammation of the pericardium, a sac-like layer that covers the heart. The pericardium contains a fluid that keeps the heart muscle moist and ensures a smooth function
• Generally, this sac becomes inflamed due to an underlying condition that results in friction between the membrane and muscle causes a stabbing chest pain, thereby leading to pericarditis
• Dressler Syndrome can lead to signs and symptoms that include chest pain, breathing difficulties, and fatigue. If left untreated, it can cause complications that include  pulmonary edema, cardiac tamponade, and shock
• The treatment of Dressler Syndrome primarily involves the administration of high-dose aspirin. The prognosis depends on the severity of the underlying cause; although in most cases with appropriate treatment, it is good

Who gets Dressler Syndrome? (Age and Sex Distribution)

• Dressler Syndrome is a rare form of pericarditis that occurs in the background of an injury to the chest/heart
• It is more common in individuals in the 20-50 year age group
• Both males and females may be affected, though the condition is more common in males
• No racial, ethnic, or geographical preferences are seen

What are the Risk Factors for Dressler Syndrome? (Predisposing Factors)

Dressler Syndrome risk factors may include the following:

• Post heart attack or myocardial infarction
• Trauma to the chest due to other reasons such as a surgery or an accident
• A previous diagnosis of acute pericarditis may increase the risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Dressler Syndrome? (Etiology)

• The cause of Dressler Syndrome is generally unknown
• It is believed to be an autoimmune reaction of the body following an injury to the heart, such as due to a heart attack, surgery, or trauma to the chest

What are the Signs and Symptoms of Dressler Syndrome?

The signs and symptoms of Dressler Syndrome include, but are not limited to, the following:

• Low-grade fever, chills, sweating
• Chest pain; pain in chest increases on coughing or swallowing
• Dry cough
• Fatigue, anxiety
• Difficulty breathing, which gets worse especially while reclining or lying down, but gets better on sitting, leaning forward or standing
• Rapid heart rate, heart palpitations
• Pain in the back
• Swelling of the legs and feet (edema)
• Signs and symptoms of the underlying condition or disorder

The signs and symptoms may be observed 2-3 weeks after the heart attack (or chest trauma). In some cases though, it may develop after many months.

How is Dressler Syndrome Diagnosed?

A diagnosis of Dressler Syndrome may be made as follows:

• A thorough physical examination with a complete medical history (including history of a recent heart attack, surgery to the chest, or an injury to the chest region)
• If symptoms are noted, the healthcare provider may need a full medical history to correlate the condition and rule out other possible causes of infection
• A stethoscope is used to listen to the heartbeat; if a faint sound is heard, it can usually raise suspicion/concern for the healthcare provider

A series of tests to view structures and fluid present in the heart may then be ordered, for further observation of the condition. These tests may include:

• Erythrocyte sedimentation ratio (ESR) test; elevated ESR levels may be observed
• Blood tests
• X-ray of chest
• CT or MRI scan of the chest
• Echocardiogram

The radiology imaging tests may show the presence of any abnormal fluid levels around the heart, within the pericardial sac.

• Sometimes, depending on the clinical situation, abnormal fluid in the pericardial sac may be cultured, to determine if there is an infectious cause
• The fluid is collected by aspiration through a procedure called pericardiocentisis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Dressler Syndrome?

The following complications may occur due to Dressler Syndrome:

• Constrictive pericarditis, a condition wherein the heart function is restricted, due to compression by the surrounding pericardial sac
• Swelling of the lungs (pulmonary edema)
• Cardiac tamponade (accumulation of excess fluid)
• Shock: A condition which can result in failure of vital organs in the body
• Complications that arise from severe heart damage due to heart attack
• The condition may recur (recurrent pericarditis) or last for many years (chronic pericarditis)

How is Dressler Syndrome Treated?

The treatment of Dressler Syndrome may include the following measures:

• Administration of high-dose aspirin usually forms the first line of treatment
• Individuals, who do not respond to high-dose aspirin therapy, may be given steroids. Typically, steroids should be avoided to the extent possible
• The use of medications to manage pain such as:
  • Analgesics (to relieve pain)
  • Anti-inflammatory medication (to decrease inflammation)
• Plenty of rest (bed rest) will be recommended as well
• If there is a severe buildup of fluid, a small cut is made in the pericardium, to allow drainage of the fluid. This procedure is called pericardiocentesis
• Additionally, diuretics to help decrease excess fluid accumulation in the body, may be administered
• The treatment for recurrent pericarditis (arising from acute pericarditis) is using colchicine medication

How can Dressler Syndrome be Prevented?

• Currently, Dressler Syndrome is a condition of the heart that may not be preventable
• However, appropriate and early management of any trauma to the heart or chest region may result in reducing the risk for the same

What is the Prognosis of Dressler Syndrome? (Outcomes/Resolutions)

• Dressler Syndrome can lead to life-threatening symptoms, if the condition is left untreated. The prognosis also depends on the severity of the signs and symptoms of the underlying condition
• If the condition is diagnosed early and treated effectively, the affected individuals typically make a full recovery

Additional and Relevant Useful Information for Dressler Syndrome:

• Dressler Syndrome should not be confused with ‘Dressler syndrome of hemoglobinuria’, which is a completely different medical condition

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/common-procedures/procedures-laboratory/pericardial-fluid-analysis/