Dressler disease develops 2 to 10 weeks after a myocardial infarction and causes pericardial and pleural effusion. These effusions are often hemorrhagic and can lead to cardiac tamponade.
Your doctor may listen to your heart with a stethoscope and order blood tests to measure inflammation, such as a high C-reactive protein and erythrocyte sedimentation rate. Your healthcare provider might also want to do an echocardiogram.
Symptoms
Dressler syndrome is a type of pericarditis, or inflammation of the sac that surrounds your heart (pericardium). This condition may develop 2 to 10 weeks after your myocardial infarction or heart surgery. It is characterized by chest pain and fever. The pain is usually sharp and pleuritic, and it may get worse when you take deep breaths or move. The fever is a sign of ongoing inflammation in the pericardium.
Your doctor will diagnose the disorder by examining you and listening to your heart and lungs with a stethoscope. Your doctor might hear a rubbing sound, called pericardial friction rub, or a heart murmur. The heart murmur is caused by fluid buildup in the covering of your heart or in the space around the lungs (pericardial effusion).
An echocardiogram is used to check for the presence of fluid in the pericardium and how much fluid is present. Your doctor might also order blood tests to measure the levels of inflammatory proteins and white blood cells in your blood. These tests will help your doctor determine if you have Dressler syndrome.
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Treatment for Dressler syndrome typically involves reducing the amount of fluid in your body. Your doctor can drain excess fluid from your pericardium using a needle or catheter. This procedure is called pericardiocentesis. It is important to have this procedure done quickly, as the accumulation of fluid can lead to cardiac tamponade and constrictive pericarditis.
Constrictive pericarditis is when the pericardium becomes thick and scarred from long-term inflammation. It reduces your hearts ability to pump blood and can cause other serious problems. Your doctor might need to drain more fluid from your pericardium, or he or she might decide to remove the pericardium completely.
Although there is no way to prevent Dressler disease, you can lower your risk of developing the condition by following a healthy lifestyle and taking all of your medications as prescribed. In addition, it is important to communicate with your health care provider about any symptoms that you are experiencing.
Diagnosis
Dressler syndrome is thought to occur in people who have recently had a heart attack or other heart surgery, when the body’s normal immune system response (to help fight infection) causes an excessive amount of inflammation in the pericardium. This can lead to a pleural effusion and other symptoms.
People with Dressler disease may feel chest pain that is sharp and aching. It may be more noticeable when they take a deep breath or move around. They might also have a low-grade fever. A doctor will do a physical examination and listen to their heart with a stethoscope. They will also look for the characteristic pericardial rub, which is a scratchy sound that occurs when the inflamed pericardial layers rub against each other.
They will also order blood tests, including a complete blood count and blood cultures, and other tests to measure inflammation markers like C-reactive protein and erythrocyte sedimentation rate. They might also do an echocardiogram to see if there is fluid in the pericardium and how much. They might also want to do a CT scan or an MRI to check for a heart-related injury or complications such as cardiac tamponade.
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A person with Dressler syndrome will usually improve with a few weeks of treatment. It’s important to follow your doctor’s instructions and go to all of your appointments. If you don’t, the symptoms can recur and can be serious.
If untreated, the pericardial effusion can cause cardiac tamponade, which is a life-threatening condition in which too much fluid pushes on your heart. Cardiac tamponade reduces the heart’s ability to pump blood and can cause heart failure.
To treat Cardiac Tamponade, your doctor will need to drain the excess fluid from your pericardial sac. This is done through a procedure called pericardiocentesis. A needle or catheter is inserted into the pericardial sac and excess fluid is removed. This decreases the pressure on your heart and can relieve symptoms, but it can be dangerous in rare cases. If complications develop, your doctor may need to remove the pericardium (pericardiectomy). This is a more drastic treatment but can be effective in reducing the risk of relapses or other heart problems.
Treatment
Dressler Disease is inflammation of the sac that surrounds the heart (pericardium). It usually occurs after damage to the heart tissue or the pericardium from a heart attack, surgery, or traumatic injury. Symptoms include chest pain that feels like a heart attack, and fever. It may also cause a buildup of fluid in the pericardial sac. People with Dressler Syndrome also have a higher risk of other heart problems, including infection, lung diseases, and heart failure.
The earliest signs of Dressler Disease are a sudden, sharp pain in the center or left side of the chest. This chest pain is called pericardial friction syndrome, and it can also feel like a heart attack or flu-like symptoms. This pain gets worse when you move or take deep breaths. Other signs of the condition include fever, an elevated white blood cell count, and a pleural effusion.
The diagnosis is made based on the history of a recent MI, clinical symptoms, and findings on physical exam. A CT scan or MRI may be used to check for a pericardial effusion.
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A pericardial effusion causes inflammation that can lead to other serious heart complications. If it is not treated, the fluid can lead to cardiac tamponade and constrictive pericarditis. If fluid reaccumulates, it can lead to repeated pericardiocentesis and a higher chance of developing chronic inflammatory response with a high risk of cardiac rejection.
Treatment options include nonsteroidal anti-inflammatory drugs, which can help reduce pain and swelling. Corticosteroids can also be used in severe cases. In addition, a procedure called pericardiocentesis can be done to remove excess fluid from the pericardium.
Dressler Syndrome is a rare condition, but it can be fatal if it isn’t treated. The key is to seek emergency care when you have the symptoms. Your doctor can diagnose the condition and recommend treatment.
The most common complication of Dressler Syndrome is an effusion in the pericardial sac. In some cases, the pericardial effusion will resolve on its own. Other times, your doctor will have to drain the fluid. This can be difficult if the fluid is large or has been present for a long time.
Prevention
While there is no way to prevent Dressler Disease, there are ways to reduce your risk of it. This includes avoiding smoking and excessive alcohol use, controlling chronic health conditions like high blood pressure, cholesterol, diabetes or heart disease, and getting regular physical activity. It is also important to get adequate rest and manage stress levels.
The exact cause of Dressler Syndrome isn’t known, but it likely occurs when a heart attack or surgery triggers an immune response in the pericardium. The body typically sends immune cells and antibodies to repair the damaged tissue, but this response can sometimes cause too much inflammation and fluid buildup in the sac around the heart (pericardial effusion).
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Fluid buildup in the pericardium puts pressure on the heart and limits its ability to pump blood efficiently. This can lead to symptoms such as chest pain, fever, fatigue and shortness of breath.
In severe cases, the heart may begin to compress or “tamponade,” leading to a loss of blood flow and coma. The treatment for Dressler Syndrome depends on the severity of your condition and your symptoms. For mild to moderate symptoms, you can take nonsteroidal anti-inflammatory drugs (NSAIDs). If the symptoms aren’t relieved by NSAIDs, your doctor might prescribe corticosteroid medications to suppress the immune system.
A health care provider can check for signs of the condition by doing a physical examination and listening to the heart with a stethoscope. This can help detect a sound called a pericardial rub, which happens when the pericardium is inflamed and fluid is collecting around it.
A complete blood count can show increased white blood cell counts in people with Dressler Syndrome. The medication colchicine might help reduce these counts by preventing the activation of the NLRP3 inflammasome. It is an inexpensive drug with a good safety profile and few reported serious side effects. It’s also been shown to improve remission rates and reduce recurrence of pericarditis in people with acute post-myocardial infarction syndrome. In combination with acetaminophen, it may be used to treat the symptoms of Dressler Syndrome.
