Dressler's Syndrome is an inflammation of the pericardium, the sac that surrounds the heart. The primary cause is generally believed to be an excessive response by the immune system as it sends antibodies and cells to an injured area after heart tissue or the surrounding sac is damaged, like after a heart attack or other chest trauma.
Within days, weeks, or even months of a heart attack, surgery, or other traumatic event to the heart region, Dressler's Syndrome can set in. It usually appears as a self-limiting, fairly mild illness. The main symptom is chest pain that can be of a similar nature as a heart attack and a low-grade fever but it may also include anxiety, breathing problems, a fast heart rate, malaise, and a dry cough. When the heart is listened to with a stethoscope, a characteristic rubbing sound can be heart.
If not treated, complications are rare but can still occur, such as thick scarring and excess build-up of fluids in the pericardium. This can put pressure on the heart and harm its ability to pump blood efficiently and effectively. Complications are often associated with other conditions that may co-exist with Dressler's Syndrome such as pleurisy and pleural effusion.
Chest pain that won't go away should always be seen by a physician. Tests will be performed to make sure Dressler's Syndrome is the correct diagnosis. This will probably include a complete examination, listening to the patient's heart with a stethoscope, and may also include an x-ray or MRI of the chest to see if there is fluid building up, an echocardiogram, an electrocardiogram, or blood tests to check for signs of inflammation.
Over-the-counter medications can be effective for the pain and inflammation associated with Dressler's Syndrome and a doctor may recommend the use of aspirin or ibuprofen to help treat these symptoms. Colchicine may also be prescribed. If these drugs aren't helpful, there are other prescription medications such as steroids that can help as well, but these carry more significant side effects and are used only if other medications absolutely can't resolve the issues and restore regular heart function.
Other treatments for severe cases may include drainage of excess fluids, using a local anesthetic, or even removal of the pericardium as a last resort if the inflammation becomes restrictive. These more invasive and unpleasant procedures are generally more associated with Dressler's Syndrome that came about as a result of surgery.
To avoid Dressler's Syndrome as a result of heart surgery, anti-inflammatory drugs are usually used to reduce the risk. Other methods of prevention are still being tested and debated.
Dressler's Syndrome can, unfortunately, come back even for patients who seek treatment and go on to improve. Relapse is estimated to happen for around ten to fifteen percent of patients. If it's not treated and goes on to get worse, Dressler's Syndrome can be fatal, but the outcome is generally favorable with treatment. Most cases are resolved within weeks.