Dressler’s syndrome, or post-infarction syndrome, most often occurs a few weeks after the patient’s myocardial infarction. According to statistics, no more than six percent of patients who have had myocardial infarction suffer from this disease in its usual form. If we take into account various low-symptom and atypical forms of pathology, then the statistical probability of developing the disease will reach 22 percent.
Dressler syndrome is characterized by symptoms of heart and lung diseases that are not related to myocardial infarction. It is pleurisy, pericarditis and pneumonitis. In addition, the synovial membranes of nearby joints can also pass the inflammation. However, it is rarely possible to meet a patient who has all three symptoms at the same time.
Most often, patients who have had myocardial infarction develop pericarditis - inflammation of the pericardium. Its symptoms are chest pains, fever. The doctor, after performing a number of special procedures and analyzes, can detect an increased ESR, leukocytosis in the patient and when listening to hear noises emitted by the pericardium in contact with other tissues of the chest. As for pains, they are usually constant, localized somewhere behind the sternum and can be given to the area between the shoulder blades, while if the patient takes a breath, the pain intensifies.
Dressler's syndrome, expressed by pericarditis, is characterized by the fact that the pain does not last longer than two to three days, and after this time they pass without any treatment. At this time, inflammation in the pericardium decreases, and exudate begins to form - a fluid that fills the pericardial cavity. In this case, the exudate can be both hemorrhagic - due to bleeding, and serous - produced by the mucous glands. The accumulation of this fluid in the pericardial cavity can be determined by several signs: the previously audible noise of friction disappears, heart sounds become muffled.
Another symptom that manifests Dressler's syndrome is pleurisy, that is, inflammation of the pleura. It can be both dry and exudative. In the first case, the doctor can clearly identify when listening to the noise arising from friction of the pleura. Exudative pleurisy is characterized by the accumulation of a large amount of fluid in the pleural cavity, due to which noises disappear, the sound becomes dull during percussion (tapping).
Since the accumulated exudate significantly reduces the maximum volume of inhaled air, the patient has difficulty breathing, shortness of breath and pain when inhaling.
The third symptom that can appear when Dressler syndrome develops is pneumonitis. It occurs much less frequently than the manifestations of the pathology described above. Most often, foci of inflammation are in the lower parts of the lungs. In this case, the patient experiences pain during breathing; there is always blood in the sputum produced by coughing. With percussion, a dull sound is noted, wheezing is heard. In the treatment of pneumonitis, it is important that antibiotics do not give a positive effect, which is achieved only with the use of corticosteroids.