As Dressler’s syndrome is referred to a special form of pericarditis, which is not due to pathogens, but on a kind of delayed reaction of the immune system damaged heart muscle tissue. The triggering factor can be a heart attack, a heart muscle injury, or an operation on the heart. Typical inflammatory reactions such as fever and leukocytosis usually set in, and often a pericardial or pleural effusion.
What is Dressler Syndrome?
Abbreviated as EODS by abbreviationfinder, dressler syndrome is an atypical inflammation of the heart muscle (myocarditis) that is associated with typical inflammatory symptoms, but without any detectable pathogens being involved in the inflammation. In this case, the immune system did not react to pathogenic germs, but rather in a kind of autoimmune reaction to dead myocardial tissue.
It is heart muscle tissue that has been necrotized as a result of a heart attack, injury, or surgery. The typical inflammatory reactions that can then appear with a time delay of a few days to several weeks, in some cases even up to two months, are comparable to those that occur after a typical bacterial infection.
In both cases, it is the immune system that is causing the symptoms. There are also cases observed, which are repeated chest pain comes to those of angina are similar and thus a re-myocardial infarction “pretend”.
Causes
Dressler’s syndrome is always associated with necrotic myocardial tissue, but the processes that cause such a late reaction of the immune system are not (yet) fully understood. It is highly probable that immune complexes will form in the dead tissue.
Immune complexes consist of an antigen and antibodies in the form of immunoglobulins that can bind to the antibodies. In this case, the antigen consists of partially degraded myocardial cells, i.e. the body’s own cell substance, which is marked by the immune system and “released” for further degradation. The Dressler syndrome is therefore an autoimmune-like reaction.
The prerequisite for the development of the disease are always destroyed myocardial cells, such as those caused by a heart attack, injuries or surgical interventions on the heart or on the heart valves.
Symptoms, ailments & signs
Dressler syndrome can be accompanied by a variety of specific and non-specific symptoms, such as general signs of inflammation. Often a fever occurs, as is seen with many “real” infectious diseases, but other signs that indicate inflammation can also be observed. Typical is the occurrence of pericarditis, an inflammation of the pericardium with frequently observed fluid entry.
In many cases, pleurisy (inflammation of the pleura) and pneumonia (inflammation of the lungs) also occur. The pleurisy or pleurisy may show up as a visible sign of bloody sputum. Pneumonia is also often accompanied by an accumulation of fluid called a pleural effusion. As a rule, typical inflammatory reactions can also be determined in the laboratory.
Most of the time, leukocytosis appears with a significant increase in leukocytes, which indicates an acute inflammatory situation. There is also an increase in C-reactive plasma proteins (CRP), which can always be interpreted as an indication of acute inflammation. Dressler syndrome can also be accompanied by chest pain that resembles that of a myocardial infarction without, for example, an abnormal ECG result.
Diagnosis & course
Due to the sometimes unspecific symptoms of the disease, a correct diagnosis of Dressler’s syndrome is not always easy to make. The time at which the symptoms appear is important. These typically show up two weeks to a maximum of three months after a myocardial infarction or heart surgery.
Other symptoms such as fever, general malaise and evidence of pericardial effusion should also be present. Laboratory tests should also show signs of leukocytosis and increased CRP. To confirm the diagnosis, other causes of the symptoms should be clarified and ruled out using differential diagnosis.
If left untreated, the disease can lead to a chronic course with a different prognosis. In principle, Dressler’s syndrome can be treated with medication and has a good prognosis. However, a recurrence cannot be ruled out after healing.
Complications
Dressler syndrome usually results in diseases and complications of the heart. If the syndrome is not treated, it can, in the worst case, lead to death. With Dressler’s syndrome, the patient suffers from a strong fever and is therefore restricted in his everyday life.
This often leads to inflammation in the pericardium. This can also lead to inflammation of the lungs, which then leads to coughing up blood. It is not uncommon for patients to suffer from panic attacks when they cough up blood. The person also has chest pain, which is similar to the pain of a heart attack. Dressler syndrome can, however, be treated relatively well, so that no further complications arise from it.
Various drugs are used for this, antibiotics are not effective. In severe cases, circulatory shock can also occur. This is also linked to very low blood pressure and a fast pulse. If this acute condition is not treated, death will result.
Therefore, medical intervention is necessary in this case. Timely treatment will not reduce life expectancy. Complications can arise if Dressler’s syndrome was triggered by a heart attack and this leads to paralysis and restrictions in everyday life.
When should you go to the doctor?
Since Dressler syndrome does not heal itself, a doctor must be consulted in any case. The symptoms themselves can, however, be unspecific, so that the disease is not always recognized immediately. As a rule, the doctor should be consulted if there is a fever or a strong cough after an operation.
Bloody sputum can also occur and is also an indication of Dressler’s syndrome. Most of those affected also develop inflammation in the lungs or pleura, so that medical treatment is necessary.
In many cases, Dressler’s syndrome still occurs when the person concerned is in the hospital, so that treatment with antibiotics can be initiated immediately. If the person concerned is no longer in a hospital, a general practitioner or the hospital can be visited directly. As a rule, with timely diagnosis and treatment, the disease progresses positively without complications.
Treatment & Therapy
Since Dressler’s syndrome is not any kind of infection and by no means a bacterial infection, antibiotics cannot work either. The disease is usually well treatable with medication. You can choose from ASA (acetylsalicylic acid), which we all know as the main active ingredient in aspirin, or other anti-inflammatory and anti-feverish anti -inflammatory drugs on a non-steroidal basis such as ibuprofen, diclofenac and many others.
In stubborn cases, glucocorticoids, i.e. steroid hormones such as cortisone or prednisolone, can also be used. If the Dressler syndrome is severe, life-threatening pericardial tamponade can threaten. It is a serious complication that can result from pericardial effusion. This leads to a decrease in the filling level of the heart with blood.
The pericardial tamponade is accompanied by a rapid pulse and a barely measurable low blood pressure. Almost all symptoms of an immediately life-threatening circulatory shock are met with it. To remedy the life-threatening condition, a pericardial puncture followed by a pericardial drainage may be necessary.
Outlook & forecast
Dressler syndrome leads to very serious complaints and complications. It must therefore be treated in any case, otherwise the person concerned will die. Self-healing does not occur in this syndrome.
If Dressler’s syndrome is not treated, the patients suffer from a high fever and continue to suffer from pericarditis. This is associated with severe pain, and those affected also appear tired and exhausted. It may also be an inflammation of the lungs come from, which is associated with respiratory problems. In most cases, if Dressler syndrome is not treated, the patient’s life expectancy will decrease dramatically.
Early treatment always has a positive effect on the further course of the disease and can prevent serious complications. The treatment itself is carried out by taking medication and relieving the discomfort. However, a surgical procedure is often necessary in order to limit the symptoms completely. Usually there are no particular complications. However, even with successful treatment, the life expectancy of the person affected is limited. The further course depends heavily on the exact cause of the syndrome.
Prevention
There are no direct preventive measures that could effectively prevent Dressler’s syndrome from occurring. It is advisable to pay attention to the first symptoms and signs after events such as myocardial infarction, heart surgery or heart injury, which usually precede Dressler’s syndrome.
The occurrence of the disease after the aforementioned events is not compulsive, but only occurs in a small percentage of those affected, so that preventive use of medication after a heart attack or after a heart operation is not advisable.
Aftercare
In Dressler’s syndrome, in most cases only very few follow-up measures are available to the patient. First and foremost, early and rapid treatment of the disease must be carried out in order to prevent further complications and not to reduce the life expectancy of the person affected. In the worst case, Dressler’s syndrome can lead to death if the heart muscle becomes inflamed.
Treatment itself is carried out with the help of drugs. This does not lead to any particular complications or other complaints, but the person affected should always make sure that the dose is correct, as prescribed by the doctor. It should also be noted that lubricants should not be taken over a long period of time.
A healthy lifestyle with a healthy diet can also have a very positive effect on the further course of Dressler’s syndrome. If possible, the person affected should also refrain from consuming alcohol or smoking. Tiring or stressful activities should also be avoided in order to avoid unnecessary stress on the heart. In many cases, the support and care provided by one’s own family makes a lot of sense, as this can make everyday life easier for the person concerned.
You can do that yourself
Dressler’s syndrome has the appearance of a typical inflammatory form without evidence of pathogens. Behind it, however, is a not to be underestimated myocarditis, which gradually develops due to dead myocardial tissue, after an accident, a heart operation or a heart attack. A weakened immune system is considered to be the trigger for symptoms, as the body’s own defenses cannot properly reject the necrotic tissue. This means that self-help can only be used to a limited extent.
By consistently taking prescribed medication, the syndrome can be treated relatively quickly. However, the disease can take a chronic course and show recurrent behavior. If the patient follows a few rules, these can be easily applied and implemented as part of self-help and after recovery. The focus is on a healthy lifestyle and the maintenance or stabilization and strengthening of the immune system.
We recommend sufficient exercise in the fresh air, consisting of walks in nature and gentle sports such as swimming, aqua training or tai chi. Saunas may only be made with a doctor’s approval.
Bad habits such as smoking, alcohol and drug consumption should be stopped with a view to general well-being. Eating habits should also be adjusted towards a low-fat, vitamin-rich diet that contains a lot of omega-3 fatty acids. This is especially true for those with diabetes mellitus and significant overweight.
