Dressler's syndrome

Dressler's syndrome
Dressler's syndrome
Classification and external resources
ICD-10 I24.1
ICD-9 411.0
DiseasesDB 3947

Dressler's syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of a triad of features, fever, pleuritic pain and pericardial effusion.

Dressler's syndrome is also known as postmyocardial infarction syndrome[1] and the term is sometimes used to refer to post-pericardiotomy pericarditis.

It was first characterized by William Dressler in 1956.[2][3][4]

It should not be confused with the Dressler's syndrome of haemoglobinuria named for Lucas Dressler, who characterized it in 1854.[5][6]

Contents

Presentation

Dressler's syndrome is largely a self limiting disease that very rarely leads to pericardial tamponade.[citation needed] The syndrome consists of a persistent low-grade fever, chest pain (usually pleuritic in nature), a pericardial friction rub, and /or a pericardial effusion. The symptoms tend to occur 2 weeks post myocardial infarction, but can be delayed for a few months after infarction. It tends to subside in a few days. An elevated ESR is an objective laboratory finding.

Causes

It is believed to result from an autoimmune inflammatory reaction to myocardial neo-antigens formed as a result of the MI. A similar pericarditis can be associated with any pericardiotomy or trauma to the percardium or heart surgery.

Differential diagnosis

In the setting of myocardial infarction, Dressler's syndrome occurs in about 7% of cases,[7] and typically occurs 2-3 weeks post-myocardial infarction[8]. Dressler's syndome is also known as post-myocardial infarction syndrome, post-cardiac injury syndrome and postpericardiotomy syndrome. Dressler's syndrome needs to be differentiated from pulmonary embolism, another identifiable cause of pleuritic (and non-pleuritic) chest pain in people who have been hospitalized and/or undergone surgical procedures within the preceding weeks.

Treatment

Dressler's syndrome is typically treated with NSAIDs such as aspirin or with corticosteroids.[9] However corticosteroids are reserved for rare cases and are seldom required.

References

  1. ^ Hutchcroft BJ (July 1972). "Dressler's syndrome". Br Med J 3 (5817): 49. doi:10.1136/bmj.3.5817.49-a. PMC 1788531. PMID 5039567. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1788531. 
  2. ^ Bendjelid K, Pugin J (November 2004). "Is Dressler syndrome dead?". Chest 126 (5): 1680–2. doi:10.1378/chest.126.5.1680. PMID 15539743. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=15539743. 
  3. ^ Streifler J, Pitlik S, Dux S, et al. (April 1984). "Dressler's syndrome after right ventricular infarction". Postgrad Med J 60 (702): 298–300. doi:10.1136/pgmj.60.702.298. PMC 2417818. PMID 6728756. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2417818. 
  4. ^ Dressler W (January 1959). "The post-myocardial-infarction syndrome: a report on forty-four cases". AMA Arch Intern Med 103 (1): 28–42. PMID 13605300. 
  5. ^ synd/3982 at Who Named It?
  6. ^ L. A. Dressler. Ein Fall von intermittirender Albuminurie und Chromaturie. Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, 1854, 6: 264-266.
  7. ^ Krainin F, Flessas A, Spodick D (1984). "Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram". N Engl J Med 311 (19): 1211–4. doi:10.1056/NEJM198411083111903. PMID 6493274. 
  8. ^ Khan, AH (1992). "The postcardiac injury syndromes". Clin Cardiol 15: 67–72. 
  9. ^ Gregoratos G (1990). "Pericardial involvement in acute myocardial infarction". Cardiol Clin 8 (4): 601–8. PMID 2249214. 

External links


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