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Dressler’s Syndrome

by | 20 May, 2020

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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

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.

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