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Dressler's syndrome
Classification and external resources
ICD-10 I24.1
ICD-9 411.0
DiseasesDB 3947

Dressler's 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).

Dressler's syndrome is also known as postmyocardial infarction syndrome[1] and postcardiotomy pericarditis.

It was first characterized by William Dressler in 1956.[2][3][4]

It should not be confused with the Dressler's syndrome of haemoglobinuria named for Lucas Dressler, who characterized it in 1854.[5][6]

Contents

Presentation

The syndrome consists of a persistent low-grade fever, chest pain (usually pleuritic in nature), a pericardial friction rub, and /or a pericardial effusion. The symptoms tend to occur after a few weeks or even months after infarction and tend to subside in a few days. An elevated ESR is an objective laboratory finding.

Causes

It is believed to result from an autoimmune inflammatory reaction to myocardial neo-antigens.

Dressler's syndrome is associated with myocardial infarction (heart attack), and with heart surgery.

Differential diagnosis

In the setting of myocardial infarction, Dressler's syndrome occurs in about 7% of cases,[7] and typically occurs 1 to 4 weeks after the myocardial infarction occurred, but may occur up to two years after the infract. This differentiates Dressler's syndrome from the much more common post myocardial infarction pericarditis that occurs in 17 to 25% of cases of acute myocardial infarction and occurs between days 2 and 4 after the infarction. Dressler's syndrome also 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.

Treatment

Dressler's syndrome is typically treated with NSAIDs such as aspirin or with corticosteroids.[8]

However coriticosteroids are reserved for rare cases and it is seldom required. It is largely a self limiting disease very rarely leads to pericardial tamponade.

References

  1. ^ Hutchcroft BJ (July 1972). "Dressler's syndrome". Br Med J 3 (5817): 49. doi:10.1136/bmj.3.5817.49-a. PMID 5039567.  
  2. ^ Bendjelid K, Pugin J (November 2004). "Is Dressler syndrome dead?". Chest 126 (5): 1680–2. doi:10.1378/chest.126.5.1680. PMID 15539743. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=15539743.  
  3. ^ 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. PMID 6728756.  
  4. ^ Dressler W (January 1959). "The post-myocardial-infarction syndrome: a report on forty-four cases". AMA Arch Intern Med 103 (1): 28–42. PMID 13605300.  
  5. ^ synd/3982 at Who Named It?
  6. ^ L. A. Dressler. Ein Fall von intermittirender Albuminurie und Chromaturie. Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, 1854, 6: 264-266.
  7. ^ Krainin F, Flessas A, Spodick D (1984). "Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram". N Engl J Med 311 (19): 1211–4. PMID 6493274.  
  8. ^ Gregoratos G (1990). "Pericardial involvement in acute myocardial infarction". Cardiol Clin 8 (4): 601–8. PMID 2249214.  

External links

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Wiktionary

Up to date as of January 15, 2010

Definition from Wiktionary, a free dictionary

English

Noun

Singular
Dressler's syndrome

Plural
Dressler's syndromes

Dressler's syndrome (plural Dressler's syndromes)

  1. a form of pericarditis that occurs in relation to damage to he myocardium or pericardium

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