Cardiology Letters 2025, 34(4):221-226

Dressler's syndrome - a literature review

Agata Antoniak¹, Anna Maria Jocz², Anna Centkowska³, Natalia Katarzyna Wagner-Bieleń⁴, Gabriela Helena Dąbrowska⁵, Joanna Karina Banaśkiewicz⁶, Martyna Zwierzchowska⁷, Maria Anna Żmijewska⁸, Jakub Ziółkowski⁷, Aleksandra Maria Żyta⁷

Transfiguration of the Lord, al. "Solidarności" 67, 03-401 Warsaw, Poland

Dressler's syndrome, first described in 1956, is a form of secondary pericarditis classified within the broader category of post-cardiac injury syndromes. It typically occurs several weeks after acute myocardial infarction and is believed to result from an autoimmune response triggered by myocardial necrosis. Once common, its prevalence has declined significantly due to the widespread adoption of reperfusion therapies, including thrombolysis and percutaneous coronary intervention (PCI). This review synthesizes current understanding of Dressler's syndrome, with particular attention to the recommendations of the European Society of Cardiology (ESC). Clinically, it may present with low-grade fever, chest pain, dyspnoea and elevated inflammatory markers. Diagnosis is based on specific criteria, which require at least two of the following: pleuritic chest pain, a pericardial friction rub, electrocardiographic features suggestive of pericarditis, or new or progressive pericardial effusion. Imaging techniques such as echocardiography and cardiac magnetic resonance enhance diagnostic accuracy and assist in ruling out alternative causes. Treatment involves high-dose aspirin, often used in combination with colchicine to prevent recurrence. For cases that are resistant to standard therapy, escalation to immunosuppressive agents or pericardiotomy may be necessary in carefully selected patients. In modern practice, it should still be considered in patients presenting post-MI chest pain, particularly in those with large infarctions or without prior PCI. Given that most existing literature originates from the pre-reperfusion era, there is a clear need for updated clinical insights.

Keywords: Dressler's syndrome; post-myocardial injury; pericarditis

Published: April 1, 2025  Show citation