Introduction
Dressler’s syndrome is pericarditis that develops 2-10 weeks post-myocardial infarction or heart surgery.
Pathophysiology
It is believed to result from an autoimmune reaction to myocardial neo-antigens.
Clinical features
Symptoms
Chest pain is usually:
- Sharp and well-localised
- Relieved by leaning forwards
- Radiates to the left shoulder, down the arm or into the abdomen
- Pleuritic
Signs
- Pericardial rub
- Fever
- Heart failure
- Pulsus paradoxus (>10 mmHg drop in blood pressure on inspiration) in severe cases
- Kussmaul’s sign (rise of JVP on inspiration) in severe cases
Diagnosis
Mostly based on clinical features and suggested by:
- Recent history of myocardial infarction
- Low-grade fever
- Chest pain
- Pericardial rub
Investigations
- ECG: ST elevation in all leads
- Chest x-ray: may show cardiomegaly
- Echocardiography: may show effusion
Management
Non-steroid anti-inflammatory drugs and rest. Consider pericardiocentesis and steroid if severe.
0 Comments