Overview

Dressler's syndrome is a type of pericarditis — inflammation of the sac surrounding the heart (pericardium). Dressler's syndrome is believed to be an immune system response after damage to heart tissue or to the pericardium, from events such as a heart attack, surgery or traumatic injury. Symptoms include chest pain, which may be similar to chest pain experienced during a heart attack.

Dressler's syndrome may also be called postpericardiotomy syndrome, post-myocardial infarction syndrome and post-cardiac injury syndrome. With recent improvements in heart attack treatment, Dressler's syndrome is less common than it used to be.

Symptoms

Symptoms are likely to appear weeks to months after a heart attack, surgery or injury to the chest. Symptoms might include:

  • Chest pain
  • Fever

When to see a doctor

Seek emergency care for persistent chest pain, which may indicate a recurring heart attack or other disorder.

Causes

Dressler's syndrome is associated with an immune system response to heart damage. Your body reacts to the injured tissue by sending immune cells and proteins (antibodies) to clean up and repair the affected area. Sometimes this response causes excessive inflammation in the pericardium.

Postpericardiotomy syndrome might affect 10 to 40 percent of people who have had heart surgery.

Complications

The immune system response that leads to Dressler's syndrome might also cause fluid to accumulate in the membranes around your lungs (pleural effusion).

Rarely, Dressler's syndrome can cause more-serious complications, including:

  • Cardiac tamponade. Inflammation of the pericardium can cause fluids to accumulate in the sac (pericardial effusion). The fluid can put pressure on the heart, forcing it to work harder and reducing its ability to pump blood efficiently.
  • Constrictive pericarditis. Recurring or chronic inflammation can cause the pericardium to become thick or scarred. The scarring can reduce the heart's ability to pump blood efficiently.
July 09, 2015
References
  1. LeWinter MM. Pericardial complications of myocardial infarction. http://www.uptodate.com/home. Accessed May 27, 2015.
  2. Hoit BD. Post-cardiac injury syndromes. http://www.uptodate.com/home. Accessed May 27, 2015.
  3. Hoit BD. Etiology of pericardial diasease. http://www.uptodate.com/home. Accessed May 27, 2015.
  4. Bonow RO, et al. Pericardial diseases. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed May 27, 2015.
  5. Adams JG. Pericarditis, pericardial tamponade, and myocarditis. In: Emergency Medicine: Clinical Essentials. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2013. http://www.clinicalkey.com. Accessed May 27, 2015.
  6. Imazio M, et al. Postpericardiotomy syndrome: A proposal for diagnostic criteria. Journal of Cardiovascular Medicine. 2013:14:351.
  7. Alraies MC, et al. Clinical features associated with adverse events in patients with post-percariotomy syndrome following cardiac surgery. American Journal of Cardiology. 2014;114:1426.
  8. Cantinotti M, et al. Controversies in the prophylaxis and treatment of postsurgical pericardial syndromes: A critical review with a special emphasis on paediatric age. Journal of Cardiovascular Medicine. 2014;15:847.
  9. Imazio M, et al. Cochicine for prevention of postpericardiotomy syndrome and postoperative atrial fibrillation: The COPPS-2 randomized clinical trial. JAMA. 2014;312:1016.