Dressler syndrome

From IDWiki

Background

  • Post-myocardial infarction pericarditis with or without pericardial effusion

Clinical Manifestations

  • Occurs 1 to 6 weeks after initial insult
  • Symptoms include fever, malaise, weakness, pleuritic chest pain, irritability, poor appetite, palpitations, dyspnea, and arthralgias
    • Fevers typically lower-grade but can be high-grade
  • Often tachycardic and can have pericardial friction rub on auscultation
  • Can be complicated by cardiac tamponade

Investigations

  • Echocardiogram
  • ECG can show diffuse ST elevation and T-wave inversions (as in pericarditis)
  • CBC will show a leukocytosis
  • Elevated ESR/CRP
  • Consider pericardiocentesis for cell count and differential, Gram stain and culture, cytology, protein

Management

  • NSAIDs tapered over 4 to 6 weeks
  • For failure of NSAIDs, prednison, tapered over 4 weeks
  • Sometimes colchicine