Dressler'S Syndrome

Dressler's syndrome, also known as postpericardiotomy syndrome, postmyocardial infarction syndrome and postcardiac injury syndrome, is a type of pericarditis (inflammation of the heart sac) that can follow any type of injury to the heart muscle.

Types of injueries that can lead to Dressler's syndrome include

• myocardial infarction (heart attack),
• cardiac surgery,
• blunt trauma to the chest.

Dressler's syndrome is usually a self limited condition, and can be treated easily and effectively.

Dressler's syndrome is less common than it used to be due to recent improvements in heart attack treatment.

The symptoms of Dressler's syndrome usually appear weeks to months after

• a heart attack,
• cardiac surgery,
• injury to the chest.

Symptoms may include chest pain and fever.         

Dressler's syndrome is caused by an immune response to damage to the heart.

When heart tissue is damaged, the body's immune system reacts by sending immune cells and proteins (antibodies) to the affected area of the heart.

These cells and antibodies clean up and repair the affected tissue. In some cases this response may cause excessive inflammation in the pericardium.

The following are used for diagnosing Dressler's syndrome:

• A physical exam, including using a stethoscope to listen to the heart. Certain characteristic sounds can indicate that the pericardium is inflammed or that fluid has accumulated around the heart.

• Echocardiogram - a test in which sound waves are used to produce an image of the heart. It can help doctors to see if fluid is accumulating around the heart.

• Electrocardiogram - electrical activity of the heart is recorded through wires that are placed on the skin. Certain changes in the electrical impulses can indicate pressure on the heart.

• Chest X-ray - to help doctors to detect if fluid has built up around the heart or lungs. It can also help to exclude other causes of symptoms, such as pneumonia.

• Blood tests to check for inflammatory activity that is consistent with Dressler's syndrome.

There are several complications associated with Dressler's syndrome.

Dressler's syndrome can lead to accumulation of fluid in the membranes around the lungs (pleural effusion).

Other complications associated with Dressler's syndrome include:

• Cardiac tamponade: Occurs due to accumalation of fluid in the pericardium (pericardial effusion). This fluid can put pressure on the heart making it to work harder than normal and reducing its pumping ability.
• Constrictive pericarditis: Occurs due to recurring or chronic inflammation which causes the pericardium to get thicker. This in turn leads to a reduction in the heart's ability to pump blood efficiently.