Dressler's syndrome is one of the many complications of myocardial infarction. These can be pneumonitis, pleurisy, pericarditis, arthritis, fever, leukocytosis, increased erythrocyte sedimentation rate and other diseases.
Features of the disease
According to some sources, the incidence of Dressler's syndrome is up to 30% of cases. In recent years, the frequency of the syndrome has decreased and this is due to the use of non-steroidal anti-inflammatory drugs and reperfusion therapies. The reason for the decrease is also considered the use of angiotensin-converting enzyme inhibitors, statins and aldosterone antagonists, as well as the fact that the disease is simply not diagnosed.
Develops usually with a large, large or complicated myocardial infarction. This is the second disease that goes somewhere 2-8 weeks after a heart attack. The basis of the syndrome is autoimmune aggression, which contributes to the development of a hyperergic reaction in a sensitized organism with a lesion of the benign character of the serosa.
On the classification and types of the Dressler syndrome we will talk further.
Those who speak English should watch the following video about the features and course of the Dresler syndrome:
Forms
- The unfolded form of the Dressler syndrome:
- pericardial( cardiac damage);
- pleural( damage to the membranes of the lungs and walls of the chest cavity);
- pneumonic( lung injury);
- pericardial-pleural-pneumonic;
- pericardial-pleural;
- pericardial-pneumonic;
- pleuro-pneumonic.
- Atypical form:
- articular( one or more joints affected);
- cutaneous( rash or redness).
- Malosymptomatic form:
- high temperature for a long period of time;
- change in the blood clinic: high leukocyte count, increased ESR, high eosinophil count;
- resistant arthralgia - joint pain.
Causes of
The main cause of Dressler's syndrome is the death of cardiac muscle cells, the release into the bloodstream of decay products, the increase of immune sensitivity. This results in the formation of altered proteins, on which immune cells react.
The disease is most often diagnosed with extensive heart damage.
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Symptoms of
The main symptoms of Dressler's syndrome include:
- poor state of health, malaise;
- increase in temperature within 37,3-39C, not more;
- pericarditis, characterized by pain in the heart, intensifying during coughing and high inspiration, and disappearing when tilted forward and in a supine position;
- pneumonitis with cough and shortness of breath during exercise;
- pleurisy with pains in the left side of the chest and cough;
- pain in the left shoulder joint, deterioration of sensitivity in the left arm and its numbness, paleness of the brushes;
- syndrome of anterior thoracic wall - osteochondrosis with pain and swelling on the left side of the chest;
- skin rashes in the form of eczema, erythema and urticaria.
Next, let's talk about the diagnosis of Dressler's syndrome.
Diagnostics
The disease can be suspected on the basis of patient complaints, after he suffered a heart attack within the last 2 months. The patient's examination data is also taken into account - when listening to the breast, it is possible to detect the noise of rubbing of the pleura and pericardium, wheezing at the bottom of the lungs.
To clarify the diagnosis, the following types of examinations are prescribed:
- an expanded blood test in which a large number of leukocytes is observed, acceleration of ESR, growth of eosinophils;
- blood biochemistry, immunological studies, rheumatological tests;
- ECG;
- echocardiography;
- chest X-ray;
- radiography of the joints of the shoulders( osteoarthrosis);
- MRI or CT of the chest to determine the nature of pleurisy, pericarditis and pneumonitis.
Treatment of Dressler's syndrome
Therapy of Dressler's syndrome, which has arisen for the first time, is treated in a hospital. Then, with repetition and a mild course, the disease is treated at home, outpatient.
The first 3 days the patient is recommended strict bed rest. It is very important for the patient to adhere to the prescribed regime of the day in the hospital.
Drug method
From medicines prescribe the following medicines:
- Dexamethasone, Prednisolone or other glucocorticoids( 30-40mg per day);
- Non-steroidal anti-inflammatory drugs such as Diclofenac, Aspirin, Indomethacin, Nimesil;
- Antibiotics are prescribed for infectious lesions of the lungs, joints and pericardium;
- cardiotropic agents for the treatment of coronary heart disease( ACE inhibitor, bettablockers, aspirin, lipid-lowering drugs);
- Thrombolysis - intravenous injection of streptokinase, urokinase or altoplase;
- with pain - Analgin plus Dimedrol.
Patients may be prescribed inhalation with oxygen, which will eliminate hypoxia and reduce heart ischemia.
Operation
In addition to treatment of medication, in the case of acute effusion of pericarditis and pleurisy, as well as the accumulation of a significant amount of fluid in the cavities, an operation is shown. This includes a pleural and pericardial puncture with removal of the effusion.
The main surgical methods include:
- Coronagraphy - a method of radiopaque method of diagnosing the blood vessels of the heart, myocardial infarction, ischemic disease;
- Angioplasty of the coronary vessels - puncture of the femoral artery and the introduction of a special catheter and contrast medium;Stenting of cardiac vessels - restoration of blood flow through the introduction of a stent( metal tubule);Aortocoronary bypass of the heart, restoring blood supply in the heart muscle.
Folk methods
Folk methods of treatment are applied in addition to the main medicamental treatment.
- Recipe 1. Take in equal proportions of 20 grams of grass: motherwort, valerian root and cumin fruit. One large spoonful of the mixture is poured 200ml of boiling water. The broth is put on a water bath for 15 minutes. Insist. Filter, squeeze and take a glass before going to bed.
- Recipe 2. Mix in equal proportions of lemon balm, valerian root, clover, hawthorn, cypress, rose petals and labradorite grass. A large spoonful of collection is poured into 400ml of boiling water and placed on a water bath for 15 minutes. Then insist 30min, filter and drink 1/3 cup 4 times a day.
Prevention of the disease
There is no primary prevention of the disease, based on the elimination of causes. In the case of early activation of patients with a heart attack, the frequency of articular abnormalities decreases.
If necessary, prescribe anti-relapse therapy:
- non-steroidal anti-inflammatory drugs that relieve inflammation and pain;
- glucocorticoids that affect the immune system.
Complications of
Very rarely develop complications after Dressler's syndrome. There are isolated cases of severe kidney damage( glomerulonephritis), vascular damage( hemorrhagic vasculitis).
In the absence of timely treatment of exudative pericarditis can go into the adhesive pericarditis, which prevents relaxing the heart muscle and promotes stagnation of blood. Diastolic heart failure may develop.
Forecast
The prognosis after the suffered Dressler syndrome for life is favorable. Loss of ability to work is temporary and lasts about 3 months, it all depends on the indications.
The disability will be determined by the frequency of recurrences of the disease recurrence. And also depends on the degree of disturbed cardiovascular functions, which are caused by pleurisy, pericarditis, infarction and joint diseases. Usually, the syndrome does not lead to disability.
The following video will tell you about vitamins that will be useful to a patient with Dressler's syndrome and other heart conditions: