What is Dressler's Syndrome?

Dressler's syndrome is an inflammatory condition that can adversely affect the physiology of the heart muscle. Named for cardiologist William Dressler who first described the condition in the 1950s, Dressler's syndrome is a form of pericarditis that can become chronic. The condition is considered to result from the body's hyperactive immuno-response to injury or illness affecting the heart. Treatment for Dressler's syndrome is centered on symptom management and may involve the use of anti-inflammatory medications.

Injury to the heart muscle will generally trigger antibody production in an effort to mend any resulting physical damage. When antibody production continues unnecessarily, it can inflame the delicate membranous tissue surrounding the heart, known as the pericardium. Pericardial inflammation often presents in the wake of sustained, physical damage originating from trauma to the heart muscle, such as what may occur during a heart attack. Also known as postmyocardial infarction syndrome, Dressler's syndrome can cause fluid accumulation within the pericardium, known as a pericardial effusion, impairing heart function.

Postmyocardial infarction syndrome is generally detected with diagnostic tests designed to evaluate the condition and functionality of the heart muscle. If pericardial effusion is suspected in conjunction with Dressler's syndrome, imaging tests, such as an echocardiogram and chest X-ray, may be used to evaluate fluid accumulation around the heart muscle. Additional laboratory testing, including a blood panel, may be performed to check for markers indicative of inflammation, such as a high white blood cell (WBC) count.

Individuals with Dressler's syndrome will generally develop signs and symptoms that can mimic those associated with a heart attack. Pericardial inflammation can induce intense chest pain that may be accompanied by shortness of breath. Some people may experience pronounced fatigue or malaise that may or may not present with a fever. If a pericardial effusion is allowed to progress, individuals may develop pallor, heart palpitations or fainting spells.

If symptoms of Dressler’s syndrome are ignored, serious complications may result. Increased fluid accumulation within the pericardium can impair the heart function. Chronic pericardial inflammation can also cause permanent damage to the pericardium, such as scarring, that can inhibit circulation and the heart's ability to flex and pump properly. Those with impaired cardiovascular function may also be at risk for developing secondary conditions such as lung inflammation, or pleurisy.

In most cases, over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to alleviate mild discomfort. Moderate cases of Dressler’s syndrome may necessitate the administration of anti-inflammatory medications to ease pericardial irritation. Additional medications may also be given to suppress the body’s immuno-response to existing inflammation. Excessive fluid accumulation or pericardial scarring may necessitate surgical catheter placement to alleviate pressure or pericardium removal.