Gabrielė Žūkaitė1, Rasa Šimoniūtytė2
1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania
2Vilnius City Clinical Hospital, Department of Internal Medicine, Vilnius, Lithuania
Abstract
Background. Dressler syndrome (DS) occurs as a result of injury to the heart or pericardium, usually 1 to 6 weeks after a myocardial infarction. The incidence is decreasing due to advanced treatment methods. Pathogenesis still remains unclear, but it is associated with autoimmune processes. Clinical DS symptoms are fever, pleuritic chest pain, and fluid in pericardial and/or pleural space (pericardial rub and murmurs may be heard).
Aim: to select and analyze the latest diagnostic and treatment recommendations for DS based on the experience of researchers and to discuss the etiology, pathogenesis and clinical symptoms.
Material and methods. A review of medical literature was performed using databases of PubMed, Elsevier, Google Scholar, and guidelines of European Society of Cardiology. The search was performed using the following keywords and combinations in English: Dressler syndrome, pericarditis, post-cardiac injury syndrome.
Results. DS can be diagnosed if two of the five diagnostic criteria are present (fever without other alternative causes, pericardial or pleural pain, pericardial or pleural effusion, fluid in pericardium or pleura, and/or increased C-reactive protein). The first-line treatment is non-steroidal anti-inflammatory drugs in combination with colchicine. In treatment-resistant DS, glucocorticoids are given without discontinuing colchicine. If recovery is not achieved even with second-line treatment, immunomodulators or intravenous immunoglobulin are prescribed, and as a last resort, pericardiectomy is performed.
Conclusion. DS has favorable prognosis if diagnosed in time, but there is a possibility of recurrence of the syndrome (colchicine is an approved medication for prevention).
Keywords: Dressler syndrome, pericarditis, post–cardiac injury syndrome.