Dressler syndrome

Dressler syndrome is a delayed form of pericarditis that appears weeks to a few months after damage to the heart muscle, most classically after a heart attack. Unlike the inflammation that occurs in the first day or two after a large infarct, Dressler syndrome is a later, immune-driven reaction, as if the body's defences belatedly turn on tissue exposed by the injury.

It is thought to be an autoimmune process: heart-muscle proteins released by the injury prompt the immune system to mount an inflammatory response against the pericardium, and sometimes the pleura around the lungs. Typical features are fever, chest pain of pericarditic type, a friction rub, a pericardial effusion, and sometimes a pleural effusion, accompanied by raised inflammatory markers.

The syndrome can also follow cardiac surgery or other heart injury (a closely related condition is post-cardiac-injury syndrome). It usually responds well to anti-inflammatory treatment such as aspirin or other nonsteroidal drugs plus colchicine. Notably, Dressler syndrome has become much less common in the modern era, probably because prompt reperfusion treatment limits the extent of heart-muscle damage.