An inflammation of the pericardium (the protective sac that surrounds the heart) is known as pericarditis. Dressler syndrome, also referred to as post-cardiac injury syndrome, post-myocardial infarction syndrome, and postpericardiotomy syndrome, is a form of pericarditis. The syndrome usually develops after a heart-related event, such as surgery or a heart attack. Dressler syndrome symptoms are thought to be autoimmune responses following a cardiac event.
The heart’s scarring, thickening, and muscular tightening can result from untreated pericardial inflammation, which can be fatal. To alleviate the Dressler syndrome symptoms, substantial doses of aspirin or another anti-inflammatory drug are typically prescribed. This illness is now extremely rare thanks to advancements in heart attack therapy.
What Exactly Triggers Dressler Syndrome?
It is unclear what causes Dressler syndrome. It is thought to occur when the pericardium undergoes an immunological reaction after cardiac procedures or an attack. When the body detects an injury, it dispatches immune cells and antibodies to aid in healing. Yet, in rare cases, inflammation caused by the immune system might become excessive.
Dressler syndrome symptoms have been linked to a number of different scenarios, including:
- Operations on the heart, including open-heart surgery and angioplasty.
- Heart angioplasty and stent insertion, or PCI for short.
- The insertion of a pacemaker.
- Heart ablation.
- Following a pulmonary vein isolation procedure.
- Injury involving a needle or other sharp object entering the chest.
How can you know if you have Dressler Syndrome?
The syndrome is characterized by a wide variety of signs and symptoms. Possible Dressler syndrome symptoms are:
- Pain in the chest, upper back, or left shoulder is exacerbated by exertion or breathing.
- Inability to breathe easily or with little effort (dyspnea). It may be harder to get a good breath of air when lying down or back.
- Discomfort caused by an irregular or abnormally fast heart rate (tachycardia).
- Fluid accumulation around the heart, or effusion.
Experiencing chest discomfort and breathing problems is a medical emergency that requires immediate attention, especially if you have recently been hospitalized for a heart attack, heart surgery, cardiac procedure, or chest damage due to an accident or injury.
How serious is Dressler syndrome?
Inflammation of the pericardium can have devastating consequences if not addressed. Sometimes, the autoimmune response that triggers Dressler syndrome also leads to pleural effusion. As a result, fluid builds up in the lining of your lungs.
Cardiac tamponade is one of the most severe consequences of chronic inflammation in the heart, yet it only occurs rarely. In this scenario, there is an accumulation of fluid in the sac that surrounds the heart. As a result, the heart cannot pump enough blood to the body because of the pressure exerted by the fluid. Consequently, an affected individual is at risk of organ failure, shock, or even death.
Constrictive pericarditis can also be caused by chronic inflammation of the heart. The pericardium might become thickened or scarred when inflammation persists for an extended period.
Diagnosis of Dressler’s Syndrome
During a comprehensive physical examination, several cues audible using a stethoscope can help your doctor detect pericardial inflammation or fluid accumulation around the heart. If your doctor thinks it’s necessary, they may suggest tests such as:
Your doctor can check for fluid accumulation around your heart by using echocardiogram imaging.
Heart electrical activity is monitored via wires affixed to the patient’s skin. When the heart is under stress, it might show up as a shift in the electrical impulses. Your doctor would probably not depend solely on an ECG to diagnose Dressler’s syndrome because of the possibility of aberrant findings following heart surgery.
An X-ray can detect fluid around the cardiovascular system and rule out other potential causes, such as pneumonia.
Cardiovascular magnetic resonance imaging (MRI) employs sound waves to produce still or moving photographs of blood flow within the heart. Pericardial enlargement can be detected with this procedure.
The white blood cell (WBC) count is typically elevated in those with Dressler syndrome symptoms.
A blood test for inflammation
Inflammation consistent with Dressler syndrome might be indicated by a high C-reactive protein level and an elevated erythrocyte sedimentation rate (sed rate).
What methods are used to treat Dressler syndrome?
The goal of treatment is to decrease inflammation. Nonsteroidal anti-inflammatory medicines (NSAIDs) such as naproxen (Aleve), ibuprofen (Advil, Motrin), or high doses of aspirin may be recommended by your doctor. You may need to take them for 4–6 weeks. Anti-inflammatory drugs such as colchicine may also be administered.
Corticosteroids, which inhibit the immune system and reduce inflammation, may be prescribed if over-the-counter anti-inflammatories fail to alleviate your symptoms. However, due to their negative consequences, corticosteroids are often reserved for extreme cases.