Dressler syndrome: Difference between revisions
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==Differential diagnosis== |
==Differential diagnosis== |
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In the setting of myocardial infarction, Dressler's syndrome occurs in about 7% of cases,<ref>{{cite journal | doi = 10.1056/NEJM198411083111903 | author = Krainin F, Flessas A, Spodick D | title = Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram | journal = N Engl J Med | volume = 311 | issue = 19 | pages = 1211–4 | year = 1984 | pmid = 6493274}}</ref> and typically occurs |
In the setting of myocardial infarction, Dressler's syndrome occurs in about 7% of cases,<ref>{{cite journal | doi = 10.1056/NEJM198411083111903 | author = Krainin F, Flessas A, Spodick D | title = Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram | journal = N Engl J Med | volume = 311 | issue = 19 | pages = 1211–4 | year = 1984 | pmid = 6493274}}</ref> and typically occurs 2-3 weeks post-myocardial infarction<ref>{{cite journal|last=Khan|first=AH|title=The postcardiac injury syndromes|journal=Clin Cardiol|year=1992|volume=15|pages=67-72}}</ref>. Dressler's syndome is also known as post-myocardial infarction syndrome, post-cardiac injury syndrome and postpericardiotomy syndrome. Dressler's 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. |
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==Treatment== |
==Treatment== |
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Revision as of 01:26, 8 August 2011
| Dressler syndrome | |
|---|---|
| Specialty | Cardiology  |
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). It consists of a triad of features, fever, pleuritic pain and pericardial effusion.
Dressler's 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 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]
Presentation
Dressler's syndrome is largely a self limiting disease that very rarely leads to pericardial tamponade. 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 2 weeks post myocardial infarction, but can be delayed for a few months after infarction. It tends 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 formed as a result of the MI. A similar pericarditis can be associated with any pericardiotomy or trauma to the percardium or heart surgery.
Differential diagnosis
In the setting of myocardial infarction, Dressler's syndrome occurs in about 7% of cases,[7] and typically occurs 2-3 weeks post-myocardial infarction[8]. Dressler's syndome is also known as post-myocardial infarction syndrome, post-cardiac injury syndrome and postpericardiotomy syndrome. Dressler's 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.
Treatment
Dressler's syndrome is typically treated with NSAIDs such as aspirin or with corticosteroids.[9] However corticosteroids are reserved for rare cases and are seldom required.
References
- ^ Hutchcroft BJ (1972). "Dressler's syndrome". Br Med J. 3 (5817): 49. doi:10.1136/bmj.3.5817.49-a. PMC 1788531. PMID 5039567.
{{cite journal}}: Unknown parameter|month=ignored (help) - ^ Bendjelid K, Pugin J (2004). "Is Dressler syndrome dead?". Chest. 126 (5): 1680–2. doi:10.1378/chest.126.5.1680. PMID 15539743.
{{cite journal}}: Unknown parameter|month=ignored (help) - ^ Streifler J, Pitlik S, Dux S; et al. (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.
{{cite journal}}: Explicit use of et al. in:|author=(help); Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ Dressler W (1959). "The post-myocardial-infarction syndrome: a report on forty-four cases". AMA Arch Intern Med. 103 (1): 28–42. PMID 13605300.
{{cite journal}}: Unknown parameter|month=ignored (help) - ^ synd/3982 at Who Named It?
- ^ L. A. Dressler. Ein Fall von intermittirender Albuminurie und Chromaturie. Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, 1854, 6: 264-266.
- ^ 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.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Khan, AH (1992). "The postcardiac injury syndromes". Clin Cardiol. 15: 67–72.
- ^ Gregoratos G (1990). "Pericardial involvement in acute myocardial infarction". Cardiol Clin. 8 (4): 601–8. PMID 2249214.
External links
- . GPnotebook https://www.gpnotebook.co.uk/simplepage.cfm?ID=-1140457467.
{{cite web}}: Missing or empty|title=(help) - For antibody to cardiac muscle
- Dressler's syndrome on CNN