Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever, pleuritic pain, pericarditis and/or pericardial effusion.
Dressler syndrome was historically a phenomenon complicating about 7% of myocardial infarctions,[7] but in the era of percutaneous coronary intervention, it is very uncommon. The disease consists of persistent low-grade fever, chest pain (usually pleuritic), pericarditis (usually evidenced by a pericardial friction rub, chest pain worsening when recumbent, and diffuse ST elevation with PR segment depression), and/or pericardial effusion. The symptoms tend to occur 2–3 weeks after myocardial infarction but can also be delayed a few months. It tends to subside in a few days, and very rarely leads to pericardial tamponade.[8] Elevated ESR is an objective but nonspecific laboratory finding.
Causesedit
It is believed to result from an autoimmune inflammatory reaction to myocardial neo-antigens formed as a result of the MI. Similar pericarditis can be associated with any pericardiotomy or trauma to the pericardium or heart surgery which is called a postcardiotomy syndrome.[citation needed]
Diagnosisedit
Differential diagnosisedit
Dressler syndrome needs to be differentiated from pulmonary embolism, another identifiable cause of pleuritic (and non-pleuritic) chest pain in people who have been hospitalized and/or undergone surgical procedures within the preceding weeks.[citation needed] ischaemic heart disease.
Treatmentedit
Dressler syndrome is best treated with high-dose aspirin. In some resistant cases, corticosteroids can be used but are not preferred (avoided) in the first month due to the high frequency of impaired ventricular healing leading to an increased rate of ventricular rupture. Other NSAIDs, though once used to treat Dressler syndrome, are less advocated and should be avoided in patients with ischemic heart disease. One NSAID in particular, indomethacin, can inhibit new collagen deposition, thus impairing the healing process for the infarcted region. Other NSAIDS should be used only in cases refractory to aspirin. Heparin should be avoided because it can lead to hemorrhage into the pericardial sac, leading to tamponade. The only time heparin could be used with pericarditis is with coexisting acute MI, in order to prevent further thrombus formation.[9]
Referencesedit
^Hutchcroft, B J (1 July 1972). "Dressler's syndrome". BMJ. 3 (5817): 49–9. doi:10.1136/bmj.3.5817.49-a. PMC1788531. PMID 5039567.
^Streifler J, Pitlik S, Dux S, et al. (April 1984). "Dressler's syndrome after right ventricular infarction". Postgrad Med J. 60 (702): 298–300. doi:10.1136/pgmj.60.702.298. PMC2417818. PMID 6728756.
^Dressler W (January 1959). "The post-myocardial-infarction syndrome: a report on forty-four cases". Arch Intern Med. 103 (1): 28–42. doi:10.1001/archinte.1959.00270010034006. PMID 13605300.
^Dressler, L. A. (1854). "Ein Fall von intermittierender Albuminurie und Chromaturie" [A case of intermittent albuminuria and chromaturia]. Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin (in German). 6: 264–6. hdl:2027/hvd.32044093329910.
^Krainin F, Flessas A, Spodick D (1984). "Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram". N Engl J Med. 311 (19): 1211–4. doi:10.1056/NEJM198411083111903. PMID 6493274.
^Hertzeanu, H; Almog, C; Algom, M (1983). "Cardiac tamponade in Dressler's syndrome. Case report". Cardiology. 70 (1): 31–6. doi:10.1159/000173566. PMID 6850684.
^Jaffe, AS; Boyle, AJ (2009). "Acute Myocardial Infarction". In Crawford, Michael H. (ed.). CURRENT Diagnosis & Treatment: Cardiology (3rd ed.). New York: McGraw-Hill. pp. 51–72. ISBN978-0-07-170199-0.
External linksedit
February 10, 2024
dressler, syndrome, confused, with, dress, syndrome, secondary, form, pericarditis, that, occurs, setting, injury, heart, pericardium, outer, lining, heart, consists, fever, pleuritic, pain, pericarditis, pericardial, effusion, specialtycardiology, also, known. Not to be confused with DRESS Syndrome Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium the outer lining of the heart It consists of fever pleuritic pain pericarditis and or pericardial effusion Dressler syndromeSpecialtyCardiology Dressler syndrome is also known as postmyocardial infarction syndrome 1 and the term is sometimes used to refer to post pericardiotomy pericarditis It was first characterized by William Dressler at Maimonides Medical Center in 1956 2 3 4 It should not be confused with Dressler s syndrome of haemoglobinuria named for Lucas Dressler who characterized it in 1854 5 6 Contents 1 Presentation 2 Causes 3 Diagnosis 3 1 Differential diagnosis 4 Treatment 5 References 6 External linksPresentation editDressler syndrome was historically a phenomenon complicating about 7 of myocardial infarctions 7 but in the era of percutaneous coronary intervention it is very uncommon The disease consists of persistent low grade fever chest pain usually pleuritic pericarditis usually evidenced by a pericardial friction rub chest pain worsening when recumbent and diffuse ST elevation with PR segment depression and or pericardial effusion The symptoms tend to occur 2 3 weeks after myocardial infarction but can also be delayed a few months It tends to subside in a few days and very rarely leads to pericardial tamponade 8 Elevated ESR is an objective but nonspecific laboratory finding Causes editIt is believed to result from an autoimmune inflammatory reaction to myocardial neo antigens formed as a result of the MI Similar pericarditis can be associated with any pericardiotomy or trauma to the pericardium or heart surgery which is called a postcardiotomy syndrome citation needed Diagnosis editDifferential diagnosis edit Dressler syndrome needs to be differentiated from pulmonary embolism another identifiable cause of pleuritic and non pleuritic chest pain in people who have been hospitalized and or undergone surgical procedures within the preceding weeks citation needed ischaemic heart disease Treatment editDressler syndrome is best treated with high dose aspirin In some resistant cases corticosteroids can be used but are not preferred avoided in the first month due to the high frequency of impaired ventricular healing leading to an increased rate of ventricular rupture Other NSAIDs though once used to treat Dressler syndrome are less advocated and should be avoided in patients with ischemic heart disease One NSAID in particular indomethacin can inhibit new collagen deposition thus impairing the healing process for the infarcted region Other NSAIDS should be used only in cases refractory to aspirin Heparin should be avoided because it can lead to hemorrhage into the pericardial sac leading to tamponade The only time heparin could be used with pericarditis is with coexisting acute MI in order to prevent further thrombus formation 9 References edit Hutchcroft B J 1 July 1972 Dressler s syndrome BMJ 3 5817 49 9 doi 10 1136 bmj 3 5817 49 a PMC 1788531 PMID 5039567 Bendjelid K Pugin J November 2004 Is Dressler syndrome dead Chest 126 5 1680 2 doi 10 1378 chest 126 5 1680 PMID 15539743 Streifler J Pitlik S Dux S et al April 1984 Dressler s syndrome after right ventricular infarction Postgrad Med J 60 702 298 300 doi 10 1136 pgmj 60 702 298 PMC 2417818 PMID 6728756 Dressler W January 1959 The post myocardial infarction syndrome a report on forty four cases Arch Intern Med 103 1 28 42 doi 10 1001 archinte 1959 00270010034006 PMID 13605300 synd 3982 at Who Named It Dressler L A 1854 Ein Fall von intermittierender Albuminurie und Chromaturie A case of intermittent albuminuria and chromaturia Archiv fur Pathologische Anatomie und Physiologie und fur Klinische Medicin in German 6 264 6 hdl 2027 hvd 32044093329910 Krainin F Flessas A Spodick D 1984 Infarction associated pericarditis Rarity of diagnostic electrocardiogram N Engl J Med 311 19 1211 4 doi 10 1056 NEJM198411083111903 PMID 6493274 Hertzeanu H Almog C Algom M 1983 Cardiac tamponade in Dressler s syndrome Case report Cardiology 70 1 31 6 doi 10 1159 000173566 PMID 6850684 Jaffe AS Boyle AJ 2009 Acute Myocardial Infarction In Crawford Michael H ed CURRENT Diagnosis amp Treatment Cardiology 3rd ed New York McGraw Hill pp 51 72 ISBN 978 0 07 170199 0 External links edit Retrieved from https en wikipedia org w index php title Dressler syndrome amp oldid 1205305061, wikipedia, wiki, book, books, library,
