Dressler Syndrome Guide: Symptoms, Causes, Diagnosis, and Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
TL;DR: Dressler syndrome is swelling and irritation of the sac around the heart (the pericardium), a condition known as pericarditis, that develops weeks to a few months after damage to the heart muscle from a heart attack, heart surgery, or a serious chest injury. It is thought to be triggered by the immune system's response to the damaged tissue. Symptoms include chest pain that can worsen with deep breaths, fever, and shortness of breath. Treatment focuses on managing pain and lowering inflammation with anti-inflammatory medicines, with procedures available for rare but serious complications.
Quick Answer
What it is: A type of pericarditis (inflammation of the sac around the heart) that develops after heart damage; also called post-myocardial infarction syndrome or post-cardiac injury syndrome.
When it starts: Weeks to a few months after a heart attack, heart surgery, or a serious chest injury.
Main symptoms: Chest pain (often worse with deep breaths), fever, and shortness of breath.
How it is diagnosed: Physical exam for a pericardial rub, blood tests for inflammation, ECG, chest X-ray, echocardiogram, and cardiac MRI.
How it is treated: Anti-inflammatory medicines (NSAIDs such as aspirin, ibuprofen, colchicine) first; corticosteroids if needed; procedures to drain fluid or remove the pericardium for serious complications.
What this guide is based on: All facts in this article come from peer-reviewed clinical sources, including the 12th edition of Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine (Elsevier, 2022), the 10th edition of Rosen's Emergency Medicine (Elsevier, 2023), and hospital-based clinical guidance reviewed by specialists. This content is for education only; consult a qualified healthcare professional for diagnosis and treatment of your own condition.
What is Dressler syndrome?
Dressler syndrome is swelling and irritation of the sac around the heart that happens after damage to the heart muscle. The damage may trigger an immune system response that causes the condition. The damage can result from a heart attack, heart surgery, or a serious injury.
Swelling and irritation of the sac around the heart is called pericarditis. Dressler syndrome is a type of pericarditis that can start after the heart muscle is damaged, so you may hear it called post-traumatic pericarditis.
The condition goes by several other names, including post-myocardial infarction syndrome, post-cardiac injury syndrome, and post-pericardiotomy syndrome.
For context, the pericardium is the thin sac that surrounds and protects the heart. When it becomes inflamed, the swelling is called pericarditis. Dressler syndrome is one of several forms of this inflammation, and it is defined by when it happens: after the heart itself has been injured.
What are the symptoms of Dressler syndrome?
Symptoms of Dressler syndrome are likely to start weeks to a few months after a heart attack, surgery, or injury to the chest.
The symptoms can include the following.
Symptom | What it looks like |
Chest pain | Pain that may get worse with deep breaths, and that can feel like heart attack pain |
Fever | Elevated body temperature caused by inflammation |
Shortness of breath | Difficulty breathing, which may worsen with fluid around the heart or lungs |
Because the chest pain of Dressler syndrome can feel like chest pain from a heart attack, it should never be ignored.
When should you seek emergency care?
Get emergency care for sudden or ongoing chest pain. This can be a symptom of a heart attack or another serious condition.
What causes Dressler syndrome?
Experts think Dressler syndrome is caused by the immune system's response to heart damage.
The body reacts to injured tissue by sending immune cells and proteins called antibodies to clean up and repair the affected area. Sometimes this response causes swelling due to the inflammation in the sac around the heart, known as the pericardium.
Dressler syndrome can happen after a heart attack or some heart surgeries or procedures. It can also happen after a serious injury to the chest, such as trauma from a car accident.
What increases the risk of Dressler syndrome?
Damage to the heart muscle increases the risk of Dressler syndrome.
The main things that cause this kind of damage are a chest injury, some types of heart surgery, and a heart attack. Anyone who has experienced one of these events carries some risk of developing the condition in the weeks or months that follow.
What are the possible complications?
A complication of Dressler syndrome is fluid buildup in the tissues surrounding the lungs, called pleural effusion.
Rarely, Dressler syndrome can cause more serious complications, summarized in the table below.
Complication | What happens | Result for the heart |
Cardiac tamponade | Swelling of the pericardium causes fluid to build up in the sac, putting pressure on the heart | The heart must work harder and does not pump blood as well as it should |
Constrictive pericarditis | Ongoing or recurring swelling causes the pericardium to become thick or scarred | The scarring can reduce the heart's ability to pump blood |
Can Dressler syndrome be prevented?
Some studies suggest that taking the anti-inflammatory medicine colchicine (Colcrys, Gloperba, others) soon after heart surgery may help prevent Dressler syndrome.
How is Dressler syndrome diagnosed?
Diagnosis of Dressler syndrome starts with a physical exam from a healthcare professional. The exam includes listening to the heart with a device called a stethoscope. A sound called a pericardial rub can happen when the pericardium is inflamed or when fluid has collected around the heart.
Tests that can help confirm the diagnosis are summarized in the table below.
Test | What it checks | What it can show |
Complete blood count | Number of white blood cells | Most people with Dressler syndrome have an increased white blood cell count |
Blood tests for inflammation | C-reactive protein and erythrocyte sedimentation rate (ESR) | A higher C-reactive protein level signals inflammation; fast-sinking red blood cells on the ESR test indicate more inflammation |
Electrocardiogram (ECG or EKG) | The heart's electrical activity | Certain changes can signal pressure on the heart, though they can also appear after heart surgery, so other tests are needed to confirm |
Chest X-ray | Structures of the chest | Fluid around the heart or lungs, and helps rule out other causes such as pneumonia |
Echocardiogram | Images of the heart made with sound waves | Whether fluid is collecting around the heart |
Cardiac MRI | Still or moving pictures of blood flow through the heart | Thickening of the pericardium |
How is Dressler syndrome treated?
Treatment for Dressler syndrome focuses on reducing inflammation and managing pain. Most people respond well to medicines, and the condition often goes away within weeks. Rarely, procedures are needed for serious complications.
What medicines are used?
Aspirin: Aspirin is often the first choice, especially for people who have recently had a heart attack, because other NSAIDs may interfere with heart healing.
Other NSAIDs: Nonsteroidal anti-inflammatory drugs such as ibuprofen can help relieve pain and reduce inflammation, though they are generally avoided soon after a heart attack.
Colchicine: This anti-inflammatory medicine is often added to NSAID treatment and may reduce the risk of the condition coming back.
Corticosteroids: If symptoms do not improve with NSAIDs and colchicine, or if they keep coming back, a healthcare professional may prescribe corticosteroids to reduce inflammation.
What procedures treat complications?
If fluid builds up around the heart and causes cardiac tamponade, a procedure called pericardiocentesis can drain the fluid using a needle and catheter.
If the pericardium becomes thickened or scarred and affects the heart's ability to pump blood, a surgery called a pericardiectomy may be needed to remove part or all of the pericardium.
What will the doctor ask in an emergency visit?
In an emergency visit for chest pain, a healthcare professional is likely to ask questions such as when the pain started, what it feels like, whether it changes with breathing or position, and whether you have recently had a heart attack, heart surgery, or a chest injury. Answering these questions as clearly as possible can help the care team reach a diagnosis faster.
Conclusion
Dressler syndrome is treatable, and most people recover well with anti-inflammatory medicines and follow-up care. If you have recently had a heart attack, heart surgery, or a chest injury and develop new chest pain, fever, or shortness of breath, contact a healthcare professional promptly. Explore our related guide for more: understanding heart health after a heart attack.
Frequently Asked Questions
Is Dressler syndrome the same as pericarditis?
Dressler syndrome is a specific type of pericarditis, which is the general term for inflammation of the sac around the heart. Dressler syndrome refers to pericarditis that develops after heart damage from a heart attack, heart surgery, or a chest injury.
How long does Dressler syndrome last?
Most cases improve within a few weeks with anti-inflammatory treatment, though symptoms can sometimes come back and need further treatment.
Can Dressler syndrome happen more than once?
Yes. Symptoms can return after initial treatment, which is one reason colchicine is often added to reduce the chance of recurrence.
Is Dressler syndrome dangerous?
Most cases are treatable and not life-threatening, but rare complications such as cardiac tamponade or constrictive pericarditis can be serious, so new or worsening chest pain should always be evaluated promptly.
How soon after a heart attack does Dressler syndrome develop?
It typically develops weeks to a few months after the heart attack, heart surgery, or chest injury, rather than immediately afterward.
Can Dressler syndrome be mistaken for another heart attack?
Yes. The chest pain can feel similar to a heart attack, which is why any new or sudden chest pain needs urgent medical evaluation to tell the two apart.
What is the difference between Dressler syndrome and post-pericardiotomy syndrome?
Post-pericardiotomy syndrome is another name for Dressler syndrome when it follows heart surgery specifically, rather than a heart attack or chest injury.
Does everyone who has a heart attack get Dressler syndrome?
No. Dressler syndrome is an uncommon reaction, and most people who have a heart attack, heart surgery, or chest injury do not develop it.
References
Health information, not medical advice. This article is for general education and is not a substitute for professional diagnosis or treatment. Always consult a qualified healthcare provider about your own health, and seek emergency care for urgent symptoms.
Comments