Dressler's syndrome - Revision history

Danbot: Add MedicationDose entries for aspirin, ibuprofen, colchicine

2026-03-20T21:10:57Z

Add MedicationDose entries for aspirin, ibuprofen, colchicine

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 **Hemodynamic instability
 *Patients should follow up as an outpatient for repeat inflammatory markers in approximately one month.<ref>Imazio M, Hoit BD. Post-cardiac injury syndromes. An emerging cause of pericardial diseases. Int J Cardiol. 2013;168(2):648–652. doi:10.1016/j.ijcard.2012.09.052</ref>
 ==See Also==

ClaireLewis at 01:21, 22 October 2020

2020-10-22T01:21:27Z

← Older revision		Revision as of 01:21, 22 October 2020
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	==Background==		==Background==
	~~Dressler's syndrome, also~~ known as late post-MI pericarditis~~, is pericarditis~~ that occurs one week to several months after a myocardial infarction~~. It is thought~~ to be immunologic and is less commonly seen after [[PE]], pericardial trauma, or pericardiectomy.<ref>Jouriles N. Pericardial and Myocardial Disease. In: Rosen's Emergency Medicine: Concepts and Clinical Practice: Volume 1. Philadelphia: Mosby/Elsevier; 2010.</ref>		*Also known as late post-MI pericarditis
			*[[Pericarditis]] that occurs one week to several months after a myocardial infarction
			**Thought to be immunologic and is less commonly seen after [[PE]], [[cardiac trauma\|pericardial trauma]], or pericardiectomy.<ref>Jouriles N. Pericardial and Myocardial Disease. In: Rosen's Emergency Medicine: Concepts and Clinical Practice: Volume 1. Philadelphia: Mosby/Elsevier; 2010.</ref>

	==Clinical Features==		==Clinical Features==
	===Signs and Symptoms===		===Signs and Symptoms===
	*Pleuritic chest pain		*Pleuritic [[chest pain]]
	*[[Fever]]		*[[Fever]]
	*Malaise		*Malaise
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	===Findings===		===Findings===
	*EKG findings characteristic of [[pericarditis]]		*[[EKG]] findings characteristic of [[pericarditis]]
	*[[Pericardial effusion]]		*[[Pericardial effusion]]
	*[[Pleural effusion]]		*[[Pleural effusion]]
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	==Evaluation==		==Evaluation==
			*[[EKG]]
	*EKG
	*Labs		*Labs
	**CBC		**CBC
	**CRP/ESR		**CRP/ESR
	**[[Troponin]]: to rule out concurrent myocarditis		**[[Troponin]]: to rule out concurrent [[myocarditis]]
	*Imaging		*Imaging
	**[[CXR]]		**[[CXR]]
	**Echocardiogram		**[[echocardiography\|Echocardiogram]]

	==Diagnosis==		==Diagnosis==
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	==Management==		==Management==
	*NSAIDs: There is no evidence that a specific NSAID has increased efficacy, so NSAID choice is typically based on whether there are other indications for an NSAID or likelihood of side effects.		*[[NSAIDs]]: There is no evidence that a specific NSAID has increased efficacy, so NSAID choice is typically based on whether there are other indications for an NSAID or likelihood of side effects.
	**[[Aspirin]] ~~dosing~~: 750 to 1000 mg ~~every six to eight hours~~, with gradual tapering of the total daily dose by 650 to 800 mg ~~every week~~ for a treatment period of three to four weeks		**[[Aspirin]]: 750-1000 mg q6-8h, with gradual tapering of the total daily dose by 650-800 mg weekly for a treatment period of three to four weeks
	**[[Ibuprofen]] ~~dosing~~: 600 to 800 mg ~~every six to eight hours~~, with gradual tapering of the total daily dose by 400 to 800 mg every week for a treatment period of three to four weeks<ref>Imazio M, Spodick DH, Brucato A, Trinchero R, Adler Y. Controversial issues in the management of pericardial diseases. Circulation. 2010;121(7):916–928. doi:10.1161/CIRCULATIONAHA.108.844753</ref>		**[[Ibuprofen]]: 600-800 mg q6-8h, with gradual tapering of the total daily dose by 400-800 mg every week for a treatment period of three to four weeks<ref>Imazio M, Spodick DH, Brucato A, Trinchero R, Adler Y. Controversial issues in the management of pericardial diseases. Circulation. 2010;121(7):916–928. doi:10.1161/CIRCULATIONAHA.108.844753</ref>
	*[[Colchicine]]: may be used in conjunction with NSAIDs<ref>Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921–2964. doi:10.1093/eurheartj/ehv318</ref>		*[[Colchicine]]: may be used in conjunction with NSAIDs<ref>Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921–2964. doi:10.1093/eurheartj/ehv318</ref>
	*[[Glucocorticoids]]: can be used for refractory Dressler's syndrome		*[[Glucocorticoids]]: can be used for refractory Dressler's syndrome
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	==References==		==References==
	<references/>		<references/>
			[[Category:Cardiology]]

Ihearttroponin at 18:24, 5 March 2020

2020-03-05T18:24:46Z

← Older revision		Revision as of 18:24, 5 March 2020
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	==Diagnosis==		==Diagnosis==
	*Need 2 of the following diagnostic criteria for acute pericarditis		*Need 2 of the following diagnostic criteria for acute pericarditis<ref>Imazio M, Gaita F, LeWinter M. Evaluation and Treatment of Pericarditis: A Systematic Review. JAMA 2015;314(14):1498–506.</ref>
	**Chest pain (typically sharp and pleuritic, improved by sitting up and leaning forward)		**Chest pain (typically sharp and pleuritic, improved by sitting up and leaning forward)
	**Pericardial friction rub		**Pericardial friction rub
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	**Suggestive ECG changes		**Suggestive ECG changes
	AND		AND
	*Appropriate time-frame: 1 week to approximately 3 months after ~~myocardial infarction~~		*Appropriate time-frame: 1 week to approximately 3 months after cardiac injury

	==Management==		==Management==
			*NSAIDs: There is no evidence that a specific NSAID has increased efficacy, so NSAID choice is typically based on whether there are other indications for an NSAID or likelihood of side effects.
			**[[Aspirin]] dosing: 750 to 1000 mg every six to eight hours, with gradual tapering of the total daily dose by 650 to 800 mg every week for a treatment period of three to four weeks
			**[[Ibuprofen]] dosing: 600 to 800 mg every six to eight hours, with gradual tapering of the total daily dose by 400 to 800 mg every week for a treatment period of three to four weeks<ref>Imazio M, Spodick DH, Brucato A, Trinchero R, Adler Y. Controversial issues in the management of pericardial diseases. Circulation. 2010;121(7):916–928. doi:10.1161/CIRCULATIONAHA.108.844753</ref>
			*[[Colchicine]]: may be used in conjunction with NSAIDs<ref>Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921–2964. doi:10.1093/eurheartj/ehv318</ref>
			*[[Glucocorticoids]]: can be used for refractory Dressler's syndrome

	==Disposition==		==Disposition==
			*Admission not typically necessary, but should be considered in patients with:
			**Myopericarditis
			**Cardiac tamponade
			**Hemodynamic instability
			*Patients should follow up as an outpatient for repeat inflammatory markers in approximately one month.<ref>Imazio M, Hoit BD. Post-cardiac injury syndromes. An emerging cause of pericardial diseases. Int J Cardiol. 2013;168(2):648–652. doi:10.1016/j.ijcard.2012.09.052</ref>

	==See Also==		==See Also==

Ihearttroponin: /* Diagnostic Criteria for Acute PericarditisImazio M, Gaita F, LeWinter M. Evaluation and Treatment of Pericarditis: A Systematic Review. JAMA 2015;314(14):1498–506. */

2020-03-05T18:12:41Z

Diagnostic Criteria for Acute PericarditisImazio M, Gaita F, LeWinter M. Evaluation and Treatment of Pericarditis: A Systematic Review. JAMA 2015;314(14):1498–506.

← Older revision		Revision as of 18:12, 5 March 2020
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	==Diagnosis==		==Diagnosis==
	~~===Diagnostic Criteria for Acute Pericarditis<ref>Imazio M, Gaita F, LeWinter M. Evaluation and Treatment of Pericarditis: A Systematic Review. JAMA 2015;314(14):1498–506.</ref>===~~		*Need 2 of the following diagnostic criteria for acute pericarditis
	*Need 2 of the following
	**Chest pain (typically sharp and pleuritic, improved by sitting up and leaning forward)		**Chest pain (typically sharp and pleuritic, improved by sitting up and leaning forward)
	**Pericardial friction rub		**Pericardial friction rub
	**New or worsening pericardial effusion		**New or worsening pericardial effusion
	**Suggestive ECG changes		**Suggestive ECG changes
			AND
	*Appropriate time-frame: 1 week to approximately 3 months after myocardial infarction		*Appropriate time-frame: 1 week to approximately 3 months after myocardial infarction

Ihearttroponin at 18:11, 5 March 2020

2020-03-05T18:11:21Z

← Older revision		Revision as of 18:11, 5 March 2020
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	**[[CXR]]		**[[CXR]]
	**Echocardiogram		**Echocardiogram

			==Diagnosis==
			===Diagnostic Criteria for Acute Pericarditis<ref>Imazio M, Gaita F, LeWinter M. Evaluation and Treatment of Pericarditis: A Systematic Review. JAMA 2015;314(14):1498–506.</ref>===
			*Need 2 of the following
			**Chest pain (typically sharp and pleuritic, improved by sitting up and leaning forward)
			**Pericardial friction rub
			**New or worsening pericardial effusion
			**Suggestive ECG changes
			*Appropriate time-frame: 1 week to approximately 3 months after myocardial infarction

	==Management==		==Management==

Ihearttroponin: /* Evaluation */

2020-03-05T18:09:21Z

Evaluation

← Older revision		Revision as of 18:09, 5 March 2020
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	==Evaluation==		==Evaluation==

			*EKG
			*Labs
			**CBC
			**CRP/ESR
			**[[Troponin]]: to rule out concurrent myocarditis
			*Imaging
			**[[CXR]]
			**Echocardiogram

	==Management==		==Management==

Ihearttroponin: /* See Also */

2020-03-05T18:05:37Z

Ihearttroponin at 18:00, 5 March 2020

2020-03-05T18:00:20Z

← Older revision		Revision as of 18:00, 5 March 2020
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	==Clinical Features==		==Clinical Features==
			===Signs and Symptoms===
			*Pleuritic chest pain
			*[[Fever]]
			*Malaise
			*Pericardial friction rub

			===Findings===
			*EKG findings characteristic of [[pericarditis]]
			*[[Pericardial effusion]]
			*[[Pleural effusion]]
			*Leukocytosis, elevated ESR or CRP<ref>Imazio M, Hoit BD. Post-cardiac injury syndromes. An emerging cause of pericardial diseases. Int J Cardiol. 2013;168(2):648–652. doi:10.1016/j.ijcard.2012.09.052</ref>

	==Differential Diagnosis==		==Differential Diagnosis==

Ihearttroponin: /* Background */

2020-03-05T17:54:49Z

Background

← Older revision		Revision as of 17:54, 5 March 2020
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	==Background==		==Background==
	Dressler's syndrome, also known as late post-MI pericarditis, is pericarditis that occurs one week to several months after a myocardial infarction. It is thought to be immunologic and is less commonly seen after [[PE]] or pericardiectomy.<ref>Jouriles N. Pericardial and Myocardial Disease. In: Rosen's Emergency Medicine: Concepts and Clinical Practice: Volume 1. Philadelphia: Mosby/Elsevier; 2010.</ref>		Dressler's syndrome, also known as late post-MI pericarditis, is pericarditis that occurs one week to several months after a myocardial infarction. It is thought to be immunologic and is less commonly seen after [[PE]], pericardial trauma, or pericardiectomy.<ref>Jouriles N. Pericardial and Myocardial Disease. In: Rosen's Emergency Medicine: Concepts and Clinical Practice: Volume 1. Philadelphia: Mosby/Elsevier; 2010.</ref>

	==Clinical Features==		==Clinical Features==

Ihearttroponin: /* Differential Diagnosis */

2020-03-05T02:41:15Z

Differential Diagnosis

← Older revision		Revision as of 02:41, 5 March 2020
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	*[[CHF]]		*[[CHF]]
	*[[PE]]		*[[PE]]
			*[[Pneumonia]]
	*[[Pneumothorax]]		*[[Pneumothorax]]
	*[[Aortic dissection]]		*[[Aortic dissection]]
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	{{ST elevation DDX}}		{{ST elevation DDX}}


	==Evaluation==		==Evaluation==

← Older revision		Revision as of 18:05, 5 March 2020
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	==See Also==		==See Also==
			*[[Myocardial infarction]]
			*[[Acute coronary syndrome]]
			*[[Pericarditis]]
			*[[Myocarditis]]

	==External Links==		==External Links==