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It's a well known fact that people who have one have one heart attack often have a second cardiac event just a few weeks to a few months later. One of the most common but least known causes of heart attack complications is Dressler's syndrome.

Robert (his real name) thought he had been extremely lucky to survive a "widowmaker" heart attack. Even though the descending artery on the left front side of his heart was almost completely blocked by a blood clot and hardened, calcified cholesterol-laden debris, he was still able to sit up, take himself to the bathroom, eat, and shower. It was a lot better than the usual alternative, which involved burial.

But about a week after his heart attack, Robert felt a great deal worse. While his original heart attack had caused almost no pain, he felt awful from head to toe. His extremities turned blue. He could not catch his breath. He could not sit up and he couldn't reach the phone to call 911. 

Several hours after the onset of symptoms, Robert's landlord came banging on the door, found him unresponsive, and called for paramedics. Robert's EKG was so irregular it could not be interpreted. He seemed near death.

In the emergency room, however, the doctors found no evidence of a second heart attack. Instead, they concluded that Robert was undergoing a commonly experienced but seldom reported complication of heart attack recovery known as Dressler's Syndrome.

What Is Dressler's Syndrome?

Of the 12 million people worldwide who suffer heart attacks, about 1 million of the survivors will develop Dressler's Syndrome. There are about 150,000 cases per year in the United States and about 200,000 cases per year in Europe.

Dressler's Syndrome is an autoimmune attack by the body itself on the damaged tissue in the heart.

When a heart attack occurs, if the damage is not overwhelming, its injured tissues adjust to reduced oxygen levels and go into a kind of hibernation. As circulation is restored, however, some of these tissues cannot readjust to normal activity and they die. They have to be "cleared out" of the heart by the immune system by antibodies that attack heart tissue the same other antibodies attack bacteria, viruses, and other germs.

What Are the Symptoms of Dressler's Syndrome?

Dressler's syndrome is to the heart a lot like influenza is to the lungs. Dressler's syndrome causes massive inflammation. The 30% of men and 40% of women who suffer little or no chest pain at all during a heart attack may have intense chest pain with Dressler's syndrome.

The character of the pain caused by Dressler's syndrome, usually is not the same kind of pain that is caused by a heart attack or angina. An acute heart attack or angina typically causes dull, crushing pain that persists for minutes or hours. Dressler's syndrome causes twisting, burning, irritant pain that may come and go.

Dressler's syndrome can also cause fever, pain that gets worse with heavy breathing, and a "squeaky heart" due to a pericardial friction rub. The rubbing sound is due to friction of the heart beating against an inflamed pericardial sac surrounding it. The squeaky or rubbing sound can interfere with sleep, especially when the person who has the syndrome lies on the left side.

Continue reading after recommendations

  • Dobrilovic N, Passik CS, Shaw R. Pseudoaneurysm of the left ventricle in the presence of Dressler's syndrome. Tex Heart Inst J. 2007. 34(2):252-3
  • Paelinck B, Dendale PA. Images in clinical medicine. Cardiac tamponade in Dressler's syndrome. N Engl J Med. 2003 Jun 5. 348(23):e8