View source for Dressler's syndrome

{{DiseaseDisorder infobox |
  Name           = Dressler&#39;s syndrome |
  ICD10          = {{ICD10|I|24|1|i|20}} |
  ICD9           = {{ICD9|411.0}} |
  ICDO           = |
  Image          = |
  Caption        = |
  OMIM           = |
  MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
  DiseasesDB     = 3947 |
}}
'''Dressler's syndrome''' is a [[acquired|secondary]] form of [[pericarditis]] that occurs in the setting of injury to the [[heart]] or the [[pericardium]] (the outer lining of the heart). 

Dressler's syndrome is also known as '''postmyocardial infarction syndrome'''<ref name="pmid5039567">{{cite journal |author=Hutchcroft BJ |title=Dressler's syndrome |journal=Br Med J |volume=3 |issue=5817 |pages=49 |year=1972 |month=July |pmid=5039567 |pmc=1788531 |doi= 10.1136/bmj.3.5817.49-a|url=}}</ref> and the term is sometimes used to refer to '''post-pericardiotomy pericarditis'''.

It was first characterized by [[William Dressler]] in 1956.<ref name="pmid15539743">{{cite journal |author=Bendjelid K, Pugin J |title=Is Dressler syndrome dead? |journal=Chest |volume=126 |issue=5 |pages=1680–2 |year=2004 |month=November |pmid=15539743 |doi=10.1378/chest.126.5.1680 |url=http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=15539743}}</ref><ref name="pmid6728756">{{cite journal |author=Streifler J, Pitlik S, Dux S, ''et al.'' |title=Dressler's syndrome after right ventricular infarction |journal=Postgrad Med J |volume=60 |issue=702 |pages=298–300 |year=1984 |month=April |pmid=6728756 |pmc=2417818 |doi= 10.1136/pgmj.60.702.298|url=}}</ref><ref name="pmid13605300">{{cite journal |author=Dressler W |title=The post-myocardial-infarction syndrome: a report on forty-four cases |journal=AMA Arch Intern Med |volume=103 |issue=1 |pages=28–42 |year=1959 |month=January |pmid=13605300 |doi= |url=}}</ref>

It should not be confused with the Dressler's syndrome of [[haemoglobinuria]] named for [[Lucas Dressler]], who characterized it in 1854.<ref>{{WhoNamedIt|synd|3982}}</ref><ref>L. A. Dressler. Ein Fall von intermittirender Albuminurie und Chromaturie. Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, 1854, 6: 264-266. </ref>

==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 [[Erythrocyte sedimentation rate|ESR]] is an objective laboratory finding.

==Causes==
It is believed to result from an [[autoimmune]] inflammatory reaction to myocardial neo-[[antigen]]s. 

Dressler's syndrome is associated with [[myocardial infarction]] (heart attack). A similar pericarditis can be associated with any pericardiotomy or trauma to the percardium or [[cardiac surgery|heart surgery]].

==Differential diagnosis==
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 several weeks after the myocardial infarction has occurred (cited from Robbins and Cotran 8th edition). 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 [[Non-steroidal anti-inflammatory drug|NSAIDs]] such as [[aspirin]] or with [[corticosteroids]].<ref>{{cite journal | author = Gregoratos G | title = Pericardial involvement in acute myocardial infarction | journal = Cardiol Clin | volume = 8 | issue = 4 | pages = 601–8 | year = 1990 | pmid = 2249214}}</ref> However corticosteroids are reserved for rare cases and are seldom required.

==References==
{{reflist|2}}

==External links==
* {{GPnotebook|-1140457467}}
*[http://www.antibodypatterns.com/cardiacmusclebody.php For antibody to cardiac muscle]
*[http://www.cnn.com/HEALTH/library/DS/00666.html Dressler's syndrome on CNN]
{{Circulatory system pathology}}

[[Category:Cardiology]]

[[de:Dressler-Syndrom]]
[[es:Síndrome de Dressler]]
[[fa:نشانگان درسلر]]
[[pl:Zespół Dresslera]]
[[pt:Síndrome de Dressler]]
[[ru:Постинфарктный синдром]]
[[Category:2Fix]]