Dressler's syndrome, or postinfarction syndrome, most often occurs a few weeks after a patient's myocardial infarction. According to statistics, no more than six percent of patients who have had a myocardial infarction suffer from this disease in its usual form. If we take into account a variety of asymptomatic and atypical forms of pathology, then the statistical probability of developing the disease will reach 22 percent.
Dressler's syndrome is characterized by symptoms of heart and lung disease not related to myocardial infarction. These are pleurisy, pericarditis and pneumonitis. In addition, inflammation can also go to the synovial membranes of nearby joints. However, it is rare to find a patient who has all three symptoms at the same time.
Most often, patients who have had a myocardial infarction develop pericarditis - inflammation of the pericardium. Its symptoms are chest pain, fever. The doctor, after conducting a series of specialprocedures and tests, can detect an increased ESR, leukocytosis in a patient and, when listening, hear the noises emitted by the pericardium when in contact with other tissues of the chest. As for pain, they are usually constant, localized somewhere behind the sternum and can radiate 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 or three days, and after this time they disappear 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 either hemorrhagic - due to bleeding, or serous - produced by the mucous glands. The accumulation of this fluid in the pericardial cavity can be determined by several signs: the previously audible friction noise disappears, the 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 that occurs during pleural friction. Exudative pleurisy is characterized by the accumulation of a large amount of fluid in the pleural cavity, due to which the noise disappears, the sound is dulled during percussion (tapping).
Because the accumulated exudate significantly reduces the maximum inhaled volumeair, the patient has difficulty breathing, shortness of breath and pain when inhaling.
The third symptom that may appear when Dressler's syndrome develops is pneumonitis. It occurs much less frequently than the manifestations of the pathology described above. Most often, foci of inflammation are located in the lower parts of the lungs. In this case, the patient experiences pain when breathing, there is always blood in the sputum when coughing. With percussion, dullness of the 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.
