Dressler Syndrome: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Dressler syndrome is characterized by inflammation of the sac surrounding the heart, or pericarditis. It is believed to occur when the immune system responds to damage to the pericardium, the sac that surrounds the heart, or to the heart itself. The damage could be from a heart attack, surgery, or a violent injury. One of the symptoms is chest discomfort, which can resemble heart attack-related chest pain.

Postpericardiotomy syndrome, post-myocardial infarction syndrome, post-traumatic pericarditis, and post-cardiac injury syndrome are some other names for Dressler syndrome.

Causes Of Dressler Syndrome

According to experts, the immune system's reaction to cardiac injury is what causes Dressler syndrome. The body reacts to tissue injury by mobilizing the immune system and proteins known as antibodies to cleanse and mend the injured area. Pericardial irritation may occasionally result from this reaction.

Following some cardiac operations or therapies, Dressler syndrome can occur.

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Symptoms Of Dressler Syndrome

Symptoms of Dressler's syndrome may include:

• Tiredness.
• Weakness.
• Elevated temperature.
• Chest, upper back, or left shoulder pain that worsens with breathing or lying down. Additionally, it may get worse as you move.
• Difficulty or effort in breathing (dyspnea). Breathing may be more difficult when you're reclining or lying down.
• Irregular heartbeat, tachycardia, or palpitations.
• Pericardial effusion is the term used to describe a buildup of fluid between the pericardium and the heart.
• Painful joints.
• Reduced appetite.

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Risk Factors Of Dressler Syndrome

Dressler's syndrome can strike people of any age or color, however, it appears to strike people most frequently in their 20s to 50s.

The following risk factors increase the likelihood of Dressler's syndrome:

• Heart attack, or myocardial infarction.
• Cardiac surgeries.
• Injuries or incidents resulting in trauma to the chest.
• Virus-induced infection.
• Previous episode of peritonitis.

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Diagnosis Of Dressler Syndrome

A medical practitioner does a thorough physical examination, which includes examining the heart with a stethoscope. A pericardial rub is a sound that can occur when fluid accumulates around the heart or the pericardium gets inflamed.

Dressler syndrome can be diagnosed using the tests listed below:

• Blood count: Dressler syndrome patients typically have increased white blood cell counts.
• Blood tests that measure inflammation: Elevated erythrocyte sedimentation rate (sed rate) and C-reactive protein may be signs of persistent inflammation associated with Dressler syndrome.
• Cardiogram, sometimes referred to as an ECG or EKG: This rapid and painless test tracks electrical signals in the heart using wires connected to the skin. Certain changes in the electrical impulses may indicate that the heart is under pressure. Dressler syndrome diagnosis requires additional test results because these changes may not go away after heart surgery.
• Radiography of the chest: A chest X-ray can be used to detect fluid around the heart or lungs. It can also help rule out more potential causes of the fluid, such as pneumonia.
• Echocardiography: If fluid is building up around the heart, it can be seen in the image of the heart that is produced by sound waves.
• Cardiac magnetic resonance imaging: This test uses sound waves to project still or moving images of the blood flow in the heart. Through this examination, the thickening of the pericardium can be examined.

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Treatment Of Dressler Syndrome

The major goals of treating Dressler syndrome are pain control and inflammation decrease. Treatment may include medication and, in the event of complications, surgery.

Medications

The main treatment for Dressler syndrome is anti-inflammatory drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like the ones listed below.

• Aspirin with ibuprofen (Advil, Motrin IB, etc.)
• If Dressler syndrome develops after a heart attack, aspirin is usually advised above other NSAIDs. Colchicine (Colcrys, Gloperba, Mitgare).
• Indomethacin can also be administered.

If those medications don't work, corticosteroids can be the next best thing. These strong immune system suppressors can reduce inflammation associated with Dressler syndrome.

Apart from the possible significant adverse effects, corticosteroids may prevent the recovery of damaged cardiac tissue after a heart attack or surgery. Because of these factors, corticosteroids are frequently saved for use when no other drug works.

Complications from Dressler syndrome may require more intrusive treatments, like:

• Removing excess fluids: Cardiac tamponade may be treated by pericardiocentesis, a surgical procedure that removes extra fluid from the heart using a catheter or tiny tube. Usually, a local anesthetic is utilized when performing the surgery.
• Pericardiectomy: Treatment for constrictive pericarditis may involve pericardiectomy or removal of the pericardium.

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Prevention Of Dressler Syndrome

According to some research, if the anti-inflammatory medication colchicine is used before heart surgery, it may be able to prevent Dressler syndrome.

Complications Of Dressler Syndrome

Pleural effusion, or an accumulation of fluid in the tissues around the lungs, is another possible consequence of the immune system reaction that causes Dressler syndrome.

Dressler syndrome can sporadically have more serious side effects, such as:

• Cardiac tamponade: The word for fluid buildup in the sac as a result of pericardial inflammation is pericardial effusion. The fluid may exert pressure on the heart, causing it to work harder and less effectively pump blood.
• Constriction of the cardiac valves: Chronic or recurrent inflammation may cause the pericardium to thicken or scar. The scarring may reduce the heart's ability to pump blood.

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