Dressler’s Syndrome (Post-Myocardial Infarction)

What is Dressler’s Syndrome?

Dressler’s syndrome – also called post-myocardial infarction, postpericardiotomy syndrome, and post-cardiac injury syndrome – is a condition that creates inflammation in the sac that surrounds the heart tissue called the pericardium. It is thought to be caused by a response in the immune system after the pericardium or heart muscle has suffered some sort of damage. Consequently, it is most frequently seen after heart attack, traumatic injury, and surgery.

In recent years, improvements have been made in how heart attacks are treated. As a result, Dressler’s syndrome is less prevalent than it has been in the past, affecting only between ten and forty percent of heart surgery patients. Most of the time it only occurs once. However, some cases see numerous recurrences for years afterwards.

What are the Symptoms of Dressler’s Syndrome?

Patients who encounter Dressler’s syndrome report symptoms appearing weeks and even months after the initial injury to the heart tissue or pericardium.

Symptoms include

  • Fever
  • Chest pain
  • Left shoulder pain that gets worse when lying down
  • Difficulty or labored breathing
  • General discomfort

Some of these symptoms can be an indication of another health concern, such as angina, pulmonary embolism, or pneumonia. So it is important to speak to a doctor to rule out those possibilities.

Dressler’s Syndrome┬áCauses

Dressler’s syndrome, a kind of pericarditis arising from irritation of the sac contiguous to the heart, is believed to be caused by an immune system reaction after injury to heart tissue. Events that can lead to damage of heart tissue include heart attack, traumatic injury or surgery. Indicators of the condition include chest pain similar to that experienced during a heart attack.

The body reacts to injured tissue by transferring immune cells and proteins to clean up and repair the affected area. This response can result in extreme inflammation in the sac surrounding the heart. Dressler syndrome can occur days, weeks, or even months following open heart surgery or a heart attack.

Some of the possible medical causes of the condition include Myocardial infarction and Coronary artery bypass graft. Some diseases similar or associated with Dressler’s Syndrome could also be causes, for example, pericardial friction rub, Postcardiotomy Pericarditis and Hemoglobinuria.

Various other general causes of the condition include chest conditions and circulatory system conditions.

How is Dressler’s Syndrome Treated?

Upon diagnosis, the focus of treatment for Dressler’s syndrome is to reduce inflammation and manage the pain. Medical professionals often recommend over-the-counter pain reliever medications like ibuprofen, naproxen, and aspirin.

If those are not effective, corticosteroids and colchicine can be prescribed. In the event of further complications, more invasive procedures may be needed. Some cases will require the draining of excess fluids or removal of the pericardium. Younger patients and those who develop a restrictive pericardium after surgery are more likely to require these invasive treatments.

Dressler’s Syndrome┬áPrevention

One important aspect in the prevention of Dressler’s Syndrome is the careful management of heart attacks so that, during heart surgery, the heart’s muscles do not deteriorate, causing complications. Recent improvements in heart condition treatments is contributing to fewer occurrences of Dressler’s syndrome. Once a person has the condition, there is a prevalence of it returning.

The use of anti-inflammatory drugs after heart surgery can lessen the risk of Dressler’s syndrome, although this is still being debated by medical professions.

Giving Colchicine after cardiac surgery can lessen the risk of developing Dressler’s syndrome by about 60%. However, it can complicate recovery and interfere with other medications.

The following medications can also be used to bring down inflammation and reduce pain: Naproxen, Aspirin, or Ibuprofen. Stronger medications like Colchicine can be prescribed if those prove ineffective.

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Last Reviewed:
September 20, 2016
Last Updated:
December 15, 2017