Dressler's syndrome: are we underdiagnosing what we think to be rare?

BMJ Case Rep. 2019 May 21;12(5):e227772. doi: 10.1136/bcr-2018-227772.

Abstract

A 46-year-old man was admitted to the emergency department with fever and pleuritic thoracic pain. Six weeks prior to admission, the patient had undergone cardiac surgery. The ECG showed diffuse ST segment elevation and PR segment depression. The blood tests revealed increased inflammatory markers and negative myocardial necrosis markers. Pericardial and left-sided pleural effusion were noted. Sterile blood cultures were negative. Hence, the hypothesis of Dressler's syndrome was established. The patient improved clinically and analytically with a short course of anti-inflammatory therapy and was discharged with colchicine and acetylsalicylic acid. A thoracic radiography performed 2 months after showed complete remission of pleural effusion.

Keywords: pericardial disease; radiology (diagnostics).

Publication types

  • Case Reports

MeSH terms

  • Aftercare
  • Anemia, Hemolytic, Autoimmune / blood
  • Anemia, Hemolytic, Autoimmune / diagnosis*
  • Anemia, Hemolytic, Autoimmune / drug therapy
  • Anemia, Hemolytic, Autoimmune / physiopathology*
  • Anti-Inflammatory Agents / therapeutic use
  • Diagnosis, Differential
  • Electrocardiography
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / metabolism
  • Pericardial Effusion / diagnostic imaging
  • Pericardial Effusion / etiology*
  • Pericarditis / diagnostic imaging
  • Pericarditis / etiology
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents

Supplementary concepts

  • Donath-Landsteiner hemolytic anemia