Dressler syndrome ds, also known as postmyocardial infarction syndrome, is a form of secondary pericarditis with or without a pericardial effusion, that occurs as a result of injury to the heart. Dresslers syndrome symptoms and causes mayo clinic. The primary symptoms are fever and chest pain, and. Yesterday it was determined the the source was dressler s syndrome a form of pericarditus. These include pneumonia, pulmonary embolism, angina, congestive heart failure chf. An acute coronary syndrome occurs when a sudden blockage in a coronary artery greatly reduces or cuts off the blood supply to an area of the heart muscle myocardium. Postcardiac injury syndrome following vascular interventional.
The 30% of men and 40% of women who suffer little or no chest pain at all during a heart attack may have intense chest pain with dressler s 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. Current incidence of postmyocardial infarction dressler s. Jun 19, 2018 complications of dressler s syndrome can require moreinvasive treatments, including. Unlike the tight, crushing, and sometimes radiating pain of a heart attack, the pain associated with dresslers tends to be sharp and stabbing. When initially described, the incidence was 3% to 4% post infarction, although this has notably decreased in the reperfusion era. There is insufficient evidence to recommend routine screening for dresslers sy ndrome. Dresslers syndrome can occur after a heart attack myocardial infarction, heart surgery, heart procedure, or chest trauma due to an accident or injury. Recommendations for the treatment of acute pericarditis. This is just inflammation induced by the immune response after an mi, as neutrophils and then macrophages make their way to the wound. Dressler syndrome after minimally invasive coronary artery.
It occurs several weeks or months after a heart attack, heart surgery, or other trauma to the heart. Dresslers syndrome diagnosis and treatment mayo clinic. Dresslers syndrome switzerland pdf ppt case reports. This condition arises due to damage to a heart tissue or the pericardium from events such as a myocardial infarction and the response of the immune system after that. The pericarditis of dresslers syndrome can begin within a couple weeks.
The syndrome can additionally include fever, malaise, leukocytosis, and elevated erythrocyte. Dresslers syndrome as a complication of atrial fibrillation ablation, po15 duration of the ahamd interval predicts occurrence of avblock during radiofrequency ablation of the slow pathway, po298 effects of the therapy with statins, angiotesinconverting enzyme inhibitors,and angiotensin ii. It consists of fever, pleuritic pain, pericarditis andor a pericardial effusion. Meigs syndrome usually occurs in postmenopausal women and resolves following removal of the.
Dressler s syndrome was originally described after acute myocardial infarction mi and its incidence seems to be declining, owing to modern reperfusion modalities. Postmyocardial infarction syndrome dresslers syndrome. Postcardiac injury syndrome pcis, also known as the postpericardiectomy or the postmyocardial infarction dressler syndrome, is characterized by combinations of pericarditis, pleuritis, and pneumonitis that develop after injury to. Dresslers sy ndrome typically occurs 2 to 10 weeks after a myocardial infarction has occurred. Dresslers 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. Takotsubo cardiomyopathy or takotsubo syndrome tts, also known as stress cardiomyopathy, is a type of nonischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion of the heart. Sometimes this response causes excessive inflammation in the pericardium. Learningradiology postpericardiotomy, syndrome, dresslers. Dec 27, 2017 postpericardiotomy syndrome pps is a febrile illness secondary to an inflammatory reaction involving the pleura and pericardium. Complications of an acute coronary syndrome heart and. Images heart illustration browse through our medical image collection to see illustrations of human anatomy and physiology see images.
It results from the bodys immunological response to a damaged. Check the full list of possible causes and conditions now. If you develop cardiac tamponade, your doctor will likely recommend a procedure pericardiocentesis in which a needle or small tube catheter is used to remove the excess fluid. Postcardiac injury syndrome was first described after myocardial infarction by dressler in 1956. The term pcis includes dressler s syndrome and postpericardiotomy syndrome pps, which occur following myocardial infarction or cardiac surgery. William dressler, american physician, 18901969 an autoimmune disorder that may occur several days to several months after acute coronary infarction, characterized by fever, pericarditis, pleurisy, pleural effusions, and joint pain. The incidence of postinfarction pericarditis has decreased to dresslers syndrome with cardiac tamponade, which was immediately punctured.
Dressler s syndrome demonstrated by late gadolinium enhancement cardiovascular magnetic resonance. The lack of blood supply to any tissue is termed ischemia. There is insufficient evidence to recommend routine screening for dressler s syndrome. Dresslers syndrome is a type of pericarditis in which inflammation of the sac surrounding the heart pericardium. We report a case of a 74yearold male with postcardiac injury syndrome.
Pleural effusions following cardiac injury and coronary. Dresslers syndrome is a type of pericarditis, inflammation of the sac surrounding the heart pericardium. The coronary arteries, which branch off the aorta just after it leaves the heart, deliver this blood. The pcis can occur after any type of cardiac injury and is thought to be due to antimyocardial antibodies. The cause of dressler syndrome is generally unknown.
I have been given drugs to hopefully reduce the fluid and will return monday for another echo to check the fluid volume. This weakening may be triggered by emotional stress, such as the death of a loved one, a breakup, rejection from a partner or constant anxiety. It is characterised by pleuritic chest pain, lowgrade fever and pericarditis autopsy shows localised fibrinous pericarditis, which may be accompanied by pericardial effusion. Sternotomy was performed after two weeks because of progressive haemodynamic. Its believed to occur when a heart surgery or heart attack triggers an immune response in the pericardium. Dressler syndrome renal disease nephrotic syndrome gynecological diseases meigs syndrome, pleural endometriosis iatrogenic diseases drugs, postthoracicabdominal surgery complications, radiation other external injury, spontaneous pneumothorax, benign asbestos pleurisy, sarcoidosis, yellow nail syndrome, pulmonary lymphangiomyomatosis. Pericarditis inflammation of the pericardium, the saclike covering of the heart after a heart attack. The principal conditions considered under this rubric are. Dresslers syndrome is a form of pericarditis that can occur after a heart attack, heart surgery, heart procedure, or chest trauma due to an. Dresslers syndrome is associated with an immune system response to heart damage. Dresslers syndrome medical definition merriamwebster. This article discusses the pleural effusions that occur with the postcardiac injury dressler s syndrome pcis and those that occur after coronary artery bypass graft cabg surgery. Dressler s syndrome is believed to be caused by the immune system attacking the area. Combining clinical trial and cystic fibrosis patient registry data.
Dressler syndrome is also known as postmyocardial infarction syndrome and the term is sometimes used to. Dressler syndrome has an incidence of approximately 5% after cardiac events, with 50% being diagnosed in the second or third week after infarction. Inflammation associated with dresslers syndrome is believed to be an immune system response following damage to heart tissue or the pericardium, such as a heart attack, surgery or traumatic injury. When the pericardial injury syndrome occurs after an acute myocardial infarction, it is also known as dressler s syndrome. Current multidetector ct scanners combine acquisition speed, high contrast and. The classic symptoms of dresslers syndrome are chest pain, a general feeling of malaise, fever, fatigue, and shortness of breath.
Dresslers syndrome, first described in 1956, is characterized by pleuritic chest pain, low grade fever and pericarditis, which may be accompanied by pericardial effusion. Dresslers syndrome definition of dresslers syndrome by. Dresslers syndrome is a pathological condition of the heart in which there is inflammation of the pericardium which is a sac like structure which surrounds the heart. Named for the polishborn american physician william dressler 18901969. Dresslers syndrome as a complication of atrial fibrillation ablation, po15 duration of the ahamd interval predicts occurrence of avblock during radiofrequency ablation of the slow pathway, po298 effects of the therapy with statins, angiotesinconverting enzyme inhibitors,and angiotensin ii receptor blocker. The character of the pain caused by dressler s syndrome, usually is not the same kind of pain that is caused by a heart attack or angina. Jul, 2019 dresslers syndrome is a type of pericarditis or inflammation of the pericardial sac. An awardwinning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, gi, cardiac and musculoskeletal diseases containing hundreds of lectures, quizzes, handout notes, interactive material, most commons lists and pictorial differential diagnoses. Meigs syndrome is the triad of ovarian tumor chapter 205, ascites, and pleural effusion. Pericarditis with or without a pericardial effusion resulting from injury of the pericardium constitutes the postcardiac injury syndrome. It is more common in patients who have undergone surgery that involves opening the pericardium.
The first page of the pdf of this article appears above. Apr 20, 2017 dresslers syndrome is a pathological condition of the heart in which there is inflammation of the pericardium which is a sac like structure which surrounds the heart. Learn about the symptoms and treatment of inflammation of the sac surrounding the heart in postcardiac injury syndromes. It is believed to be an autoimmune reaction of the body following an injury to the heart, such as due to a heart attack, surgery, or trauma to the chest. A general overview of the diagnosis, and management of dressler s. In april 1956 dressler first called at tention to a. Dressler syndrome ds is a delayed immunemediated or secondary pericarditis developing weeks to months after a myocardial infarction mi. The symptoms for dressler s syndrome starts mild and then progress to reach the full clinical profile. The pericardial sac is a saclike layer of tissue that surrounds the heart, which contains a small amount of fluid that provides lubrication for the movement of the heart. The procedure is usually done using a local anesthetic.
Terminology dressler syndrome is not to be confused with pericarditis epistenocardica which is seen ea. May 08, 2015 dressler s syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium this video contains general medical information if in doubt, always. The second type of pericarditis is also called dressler s syndrome or postcardiac injury syndrome or postcardiotomy pericarditis. Jul 23, 2009 cardiovascular magnetic resonance 5 weeks after the acute presentation showed transmural infarction and global late gadolinium enhancement of the pericardium in keeping with dressler s syndrome. Dec 27, 2017 postpericardiotomy syndrome is often associated with the development of antiheart antibodies, leading to an inflammatory reaction within the pericardial space. Inflammation associated with dresslers syndrome is believed to be an immune system response following damage to heart tissue or the pericardium, such. While recent cardiac treatment improvements have made dresslers syndrome less common than it was decades ago, a patient can suffer a recurrence. Carlo oller, emergency physician, talks about dresslers sy ndrome. Post cardiac injury syndrome may develop after myocardial infarctio n dressler syndrome, cardiac surgery or trauma. The pericardium is a tough elastic sac that surrounds the heart. Dressler s syndrome delayed pericarditis is considered as a secondary form of pericarditis resulting in the inflammation of the sac surrounding heart pericardium.
Light md, in murray and nadels textbook of respiratory medicine sixth edition, 2016. A 49year old patient presented late with an anterolateral stelevation myocardial infarction and was treated with rescue angioplasty to an occluded. Also referred to as postpericardiotomy and postmyocardial infarction syndrome, dressler s syndrome is easily treated with medications that reduce inflammation. The symptoms for dresslers sy ndrome starts mild and then progress to reach the full clinical profile. Dressler syndrome, also known as postmi syndrome, includes the development of pericarditis in the week or weeks after mi. Dresslers syndrome is about 4% following transmural infarction and probably higher in open heart surgery. What are the signs and symptoms of dressler syndrome. Your body reacts to the injured tissue by sending immune cells and proteins antibodies to clean up and repair the affected area. The effusion, which is usually large and on the right side, is formed when fluid moves from the abdomen to the pleural space through diaphragmatic defects. However, in rare cases it can occur following minor cardiac procedures. During 1980, 282 patients with documented myocardial infarction were admitted to our coronary care unit. Jun 19, 2018 dresslers syndrome is a type of pericarditis inflammation of the sac surrounding the heart pericardium. Typically, the patient demonstrates fever elevation, irritability, pericardial friction rub, and pericardial effusion with or without pleural effusion 2. Dresslers syndrome an overview sciencedirect topics.
Characteristics, prevalence, and prognosis of postmyocardial infarction syndrome. With recent improvements in the medical treatment of heart attack, dressler s syndrome is far less common than it used to be. More detailed information about the symptoms, causes, and treatments of dressler d. Carlo oller, emergency physician, talks about dressler s syndrome. Dresslers syndrome is a type of pericarditis inflammation of the sac surrounding the heart pericardium. Symptoms include chest pain, which may be similar to. Nov 20, 2017 dressler syndrome is difficult to diagnose because its symptoms are similar to those of many other conditions. Dressler graduated from the university of vienna medical school, then moved to new york to practice medicine in 1938. Dressler s syndrome typically occurs 2 to 10 weeks after a myocardial infarction has occurred.
Dresslers syndrome is a delayed type of pericarditis 1 inflammation of the protective sac surrounding the heart pericardium see figures 1 and 2 below. The heart muscle needs a constant supply of oxygenrich blood. Postinfarction pericarditis can be classified as early, referred to as pericarditis epistenocardica, or delayed, referred to as dressler syndrome. Dressler syndrome ds, also known as postmyocardial infarction syndrome, is a.
The signs and symptoms of dressler syndrome include, but are not limited to, the. Dresslers syndrome may also be called postpericardiotomy syndrome, postmyocardial infarction syndrome and postcardiac injury syndrome. Natural history, complications, and prognosis natural history. It is thought to be immunemediated antimyocardial antibodies may be. Feb 12, 2019 dressler s syndrome was first described in 1956. Dressler syndrome is also known as postmyocardial infarction syndrome. Dresslers syndrome demonstrated by late gadolinium. Get a printable copy pdf file of the complete article 285k, or click on a page image below to browse page by page.
Various viral agents, including coxsackie b, adenovirus, and cytomegalovirus, have been present in approximately two thirds of patients with postpericardiotomy syndrome, suggesting an autoimmune response associated with a viral. Dressler s syndrome percarditus postop i was doing great at 3 weeks postop. Dressler syndrome is also known as postmyocardial infarction syndrome and the term is sometimes used to refer to postpericardiotomy pericarditis. Dressler syndrome is best treated with high dose aspirin. Dressler syndrome, cardiac surgery either valve surgery or. Current incidence of postmyocardial infarction dresslers. Dresslers syndrome is a form of pericarditis, or inflammation of the pericardium. Pdf dresslers syndrome demonstrated by late gadolinium. Pdf postacute myocardial infarction ami syndrome was first described by dressler in 1956.
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