Materiały źródłowe

• #1 Post-cardiac injury syndrome: aetiology, diagnosis, and treatment

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Post-cardiac-injury-syndrome-aetiology-diagnosis-and-treatment

  Mainstays of treatment are anti-inflammatory NSAID and the adjunct use of colchicine, albeit that there are no randomised controlled trials addressing specific treatment approaches for PCIS. Treatment decisions must be taken with care given the potential side effects and risks associated with NSAID and colchicine in cardiac and post-surgery patients. Simple postoperative pericardial effusions without evidence for systemic inflammation do not warrant treatment. […] Aspirin is the first choice for patients already under antiplatelet therapy. Dosages vary between 750 mg and 1,000 mg every six to eight hours. Known coronary artery disease strongly supports the use of aspirin in such patients. A treatment period of one to two weeks before tapering is usually sufficient. Recurrent symptoms demand prolonged treatment over two to four weeks. Alternatively, ibuprofen 600 mg every eight hours may be prescribed over one to two weeks in case of initial diagnosis or over two to four weeks in case of recurrence. However, it is important to be aware that ibuprofen interferes with the antiplatelet aggregation effects of aspirin in patients after coronary bypass grafting or PCI. Treatment with NSAID is continued until symptoms resolve and CRP normalises followed by subsequent tapering. Careful monitoring of renal and cardiac function is essential. We strongly suggest administration of proton pump inhibitors for adverse gastrointestinal effects prevention. NSAID should be avoided or at least closely monitored in patients with impaired kidney function, volume depletion or known heart failure.

• #1 Dressler syndrome | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/dressler-syndrome

  The goals of treatment for Dressler syndrome are to manage pain and lower the inflammation. Treatment may involve medicines. Surgery may be needed if complications happen. […] The main treatment for Dressler syndrome is medicine to lower inflammation, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as: Aspirin, Ibuprofen (Advil, Motrin IB, others), Colchicine (Colcrys, Gloperba, others). […] If Dressler syndrome happens after a heart attack, usually aspirin is preferred over other NSAIDs. […] Indomethacin also may be given. […] If those medicines don’t help, the next step might be corticosteroids. These can lower inflammation linked with Dressler syndrome by turning down the immune system. […] Corticosteroids can have serious side effects. And they might interfere with the healing of damaged heart tissue after a heart attack or surgery. For those reasons, corticosteroids tend to be used only when other treatments don’t work.

• #1 Post-cardiac injury syndrome: aetiology, diagnosis, and treatment

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Post-cardiac-injury-syndrome-aetiology-diagnosis-and-treatment

  Colchicine has been proven effective for the reduction of recurrences in pericarditis. However, there are insufficient data on its use in PCIS treatment. One retrospective, single-centre study showed a reduction of procedural intervention if PPS was treated with colchicine in combination with an anti-inflammatory drug as compared to anti-inflammatory drugs only. This study, however, was not designed to evaluate specifically the efficacy of colchicine in PPS or PCIS. Nevertheless, the 2015 European Society of Cardiology guidelines endorsed administration of colchicine in PCIS. Dosing is the same as in PPS prevention with 0.5 mg twice a day and a dose reduction of 50% for patients weighing below 70 kg. Patients should be monitored for creatinine elevation and blood panel changes at two- to three-week intervals. Moreover, we instruct all our patients to be aware of diarrhoea and nausea heralding colchicine overdose.

• #1 Dressler’s syndrome – wikidoc

  https://www.wikidoc.org/index.php/Dressler%27s_syndrome

  Dressler’s syndrome is typically treated with high dose (up to 650 mg PO q 4 to 6 hours) enteric-coated aspirin. Acetaminophen can be added for pain management as this does not affect the coagulation system. Anticoagulants should be discontinued if the patient develops a pericardial effusion. […] Anti-inflammatory therapy is recommended in post-STEMI pericarditis as in post-cardiac injury pericardial syndromes for symptom relief and reduction of recurrences. Aspirin is recommended as first choice of anti-inflammatory therapy post-STEMI at a dose of 500-1000 mg every 6-8 h for 12 weeks, decreasing the total daily dose by 250-500 mg every 12 weeks in keeping with 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Colchicine is recommended as first-line therapy as an adjunct to aspirin/non-steroidal anti-inflammatory drug therapy (3 months) and is also recommended for the recurrent forms (6 months).

• #1 Dressler syndrome – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dresslers-syndrome/symptoms-causes/syc-20371811

  Some studies suggest that taking the anti-inflammatory medicine colchicine (Colcrys, Gloperba, others) soon after heart surgery may help prevent 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. […] Symptoms of Dressler syndrome include chest pain that can feel like chest pain from a heart attack.

• #1 A case of Dressler’s syndrome successfully treated with colchicine and acetaminophen

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7917394/

  The incidence of Dresslers syndrome after myocardial infarction (MI) has decreased in the reperfusion therapy era. […] A 69-year-old man with recent MI was admitted to our hospital. […] We diagnosed the patient with Dresslers syndrome, and colchicine 0.5 mg/day + acetaminophen 2000 mg/day were administered. His condition clinically improved after treatment and he was discharged 32 days after admission. […] Combination therapy of colchicine and acetaminophen could be a treatment option for Dresslers syndrome. […] Therefore, a combination therapy of low-dose colchicine and acetaminophen could be a treatment option for patients with Dresslers syndrome who have undergone recent coronary stenting. […] We successfully treated the patient with low-dose colchicine and acetaminophen without any side effects. […] Considering the risk of aspirin dilemma and the reported beneficial effect against recent MI, combination therapy of colchicine and acetaminophen could be a treatment option for patients with Dresslers syndrome who underwent recent coronary stenting.

• #1 Dressler syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dresslers-syndrome/diagnosis-treatment/drc-20371815

  The goals of treatment for Dressler syndrome are to manage pain and lower the inflammation. Treatment may involve medicines. Surgery may be needed if complications happen. […] The main treatment for Dressler syndrome is medicine to lower inflammation, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as: Aspirin. Ibuprofen (Advil, Motrin IB, others). Colchicine (Colcrys, Gloperba, others). […] If Dressler syndrome happens after a heart attack, usually aspirin is preferred over other NSAIDs. […] Indomethacin also may be given. […] If those medicines don’t help, the next step might be corticosteroids. These can lower inflammation linked with Dressler syndrome by turning down the immune system. […] Corticosteroids can have serious side effects. And they might interfere with the healing of damaged heart tissue after a heart attack or surgery. For those reasons, corticosteroids tend to be used only when other treatments don’t work.

• #1 Post-cardiac injury syndrome: aetiology, diagnosis, and treatment

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Post-cardiac-injury-syndrome-aetiology-diagnosis-and-treatment

  Glucocorticoid administration is required for a minority of patients with contraindications for aspirin and NSAIDs or in case of refractory symptoms. Data for PCIS are lacking, but best clinical practice suggests similar dosing to that administered in pericarditis, e.g., 0.25 to 0.5 mg/kg/d. If steroids are used, it is of the upmost importance to taper dosages very slowly to avoid recurrences. In patients treated with steroids and NSAID/colchicine, steroids must be tapered before colchicine is stopped. […] In our opinion, the best standard of care includes: colchicine for prevention of PPS, aspirin in combination with colchicine for initial treatment, and glucocorticoids for recurrence or contraindications to aspirin. Proton pump inhibitors are required in combination with aspirin.

• #1 Management of acute pericarditis: treatment and follow-up

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Management-of-acute-pericarditis-treatment-and-follow-up

  The management of myopericarditis is similar to that recommended for pericarditis. Empirical anti-inflammatory therapies (i.e. aspirin 1,500-3,000 mg/day) or NSAIDs (ibuprofen 1,200-2,400 mg/day or indomethacin 75-150 mg/day) are usually prescribed to control chest pain, while corticosteroids are prescribed as a second choice in cases of contraindications, intolerance or failure of aspirin/NSAIDs. […] The therapy includes a short course of treatment with NSAIDs, with colchicine as adjunct, especially for prevention of recurrences. Some experts suggest antiviral treatment similar to that for myocarditis, although this approach is still under evaluation and rarely used. Importantly, corticosteroids are generally not indicated in viral pericarditis, as they are known to reactivate many virus infections and thus lead to ongoing inflammation.

• #1 Dressler syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Dressler_syndrome

  The treatment of Dressler syndrome is managed with NSAIDs such as aspirin, naproxen, and ibuprofen. […] Unless a patient is hemodynamically unstable, management is done in an outpatient setting (e.g. a clinic/office). […] In some resistant cases, corticosteroids can be used but are not preferred (avoided) in the first month due to the high frequency of impaired ventricular healing leading to an increased rate of ventricular rupture. […] Some sources suggest that taking colchicine soon after surgery may help prevent Dressler syndrome.

• #1 Dressler syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dresslers-syndrome/diagnosis-treatment/drc-20371815

  Other treatments may be needed to treat complications of Dressler syndrome. These include: Draining excess fluids. For cardiac tamponade, the excess fluid can be removed with a needle or a small tube called a catheter. This treatment is called pericardiocentesis. It’s usually done using medicine called a local anesthetic that numbs a specific part of the body. […] Removing the pericardium. For constrictive pericarditis, treatment might involve surgery to remove the pericardium. The surgery is called pericardiectomy.

• #1 Dressler Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20700

  Most patients with suspected Dressler syndrome are treated in an outpatient setting with close follow-up unless the patient is hemodynamically unstable. The approach typically involves NSAIDs (e.g., aspirin, ibuprofen, naproxen) tapered over 4 to 6 weeks as the accumulated pericardial fluid diminishes. Patients who do not respond to NSAID therapy may be given a course of corticosteroids (e.g., prednisone) tapered over a 4-week period. Another potential treatment option is colchicine. Some studies suggest that taking this drug before cardiac procedures may reduce the risk of Dressler syndrome; its effectiveness, once Dressler syndrome has developed, is unclear. […] More severe cases of Dressler syndrome (i.e., symptoms that may indicate imminent cardiac tamponade or constrictive pericarditis) may require inpatient care involving pericardial drainage. Pericardiocentesis with subsequent catheter drainage (generally 24 to 48 hours) and concomitant initiation of anti-inflammatory treatment is considered the standard of care for patients with a significant pericardial effusion. If the effusion is global (surrounding the entire heart) and visible anteriorly (in front of the right ventricle), the subxiphoid approach for pericardiocentesis is recommended in addition to echocardiographic guidance.

• #1 Dressler Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441988/

  Most patients with suspected Dressler syndrome are treated in an outpatient setting with close follow-up unless the patient is hemodynamically unstable. The approach typically involves NSAIDs (e.g., aspirin, ibuprofen, naproxen) tapered over 4 to 6 weeks as the accumulated pericardial fluid diminishes. Patients who do not respond to NSAID therapy may be given a course of corticosteroids (e.g., prednisone) tapered over a 4-week period. Another potential treatment option is colchicine. Some studies suggest that taking this drug before cardiac procedures may reduce the risk of Dressler syndrome; its effectiveness, once Dressler syndrome has developed, is unclear […] More severe cases of Dressler syndrome (i.e., symptoms that may indicate imminent cardiac tamponade or constrictive pericarditis) may require inpatient care involving pericardial drainage. Pericardiocentesis with subsequent catheter drainage (generally 24 to 48 hours) and concomitant initiation of anti-inflammatory treatment is considered the standard of care for patients with a significant pericardial effusion. If the effusion is global (surrounding the entire heart) and visible anteriorly (in front of the right ventricle), the subxiphoid approach for pericardiocentesis is recommended in addition to echocardiographic guidance.

• #1 Dressler syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/dressler-syndrome-1?embed_domain=hackmd.io%2F%40yIPUAFeCSL2JsU8smR5nJQ%2Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.png&lang=us

  The clinical course is most often benign. Conservative management includes NSAIDs and colchicine. However, tamponade and free wall rupture may occur, necessitating urgent surgery. Constrictive pericarditis may be a rarely associated complication. Pericardiocentesis with fibrin-glue instillation may be tried.

• #1 Acute Pericarditis: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/156951-overview

  Surgical procedures for pericarditis include pericardiectomy, pericardiocentesis, pericardial window placement, and pericardiotomy. […] Pericardiectomy is the most effective surgical procedure for managing large effusions, because it has the lowest associated risk of recurrent effusions. This procedure is used for constrictive pericarditis, effusive pericarditis, or recurrent pericarditis, steroid dependence, and/or intolerance to other medical management. […] Patients with effusions larger than 250 mL, effusions in which size increases despite intensive dialysis for 10-14 days, or effusions with evidence of tamponade are candidates for pericardiocentesis. […] Pericardial window placement is used for effusive pericarditis therapy. In critically ill patients, a balloon catheter may be used to create a pericardial window, in which only 9 cm2 or less of pericardium is resected. […] Consider subxiphoid pericardiotomy for large effusions that do not resolve. This procedure may be performed under local anesthesia and has a lower risk of complications than pericardiectomy.

• #1 Dressler Syndrome: Causes, Diagnosis, and Treatment

  https://www.healthline.com/health/dressler-syndrome

  If you develop any complications of Dressler syndrome, more aggressive treatments may be needed: Pleural effusion is treated by draining the fluid from the lungs with a needle. The procedure is called a thoracentesis. Cardiac tamponade is treated with a procedure called pericardiocentesis. During this procedure, a needle or catheter is used to remove excess fluid. Constrictive pericarditis may be treated with surgery to remove the pericardium (pericardiectomy).

• #1 Postpericardiotomy Syndrome Treatment & Management: Medical Care, Surgical Care, Prevention

  https://emedicine.medscape.com/article/891471-treatment

  Inpatient care of patients with PPS is indicated in more severe cases, such as patients with symptoms and signs indicative of tamponade. Patients with tamponade must be admitted to the hospital for pericardial drainage. […] A surgically created pericardial window may be necessary in patients with recurrent relapses after medical- and catheter-based therapy. This may be achieved through an open thoracotomy or through a video-assisted thoracoscopic technique. […] Percutaneous balloon pericardiotomy (PBP) may be another alternative for these patients. This is a less invasive procedure in which a pericardial window is created in the catheterization laboratory using a balloon catheter under fluoroscopic guidance.

• #1 Dressler Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441988/

  Recurrence of post-pericardiotomy syndrome, including Dressler syndrome, is common, and relapses have been reported up to 1 year following the initial event. Some suggest that intravenous immunoglobulin therapy has some benefits in refractory cases, especially in children. Clinicians should remember that the number one risk factor for developing Dressler syndrome is having had it before.

• #1 Pericarditis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/myocarditis-and-pericarditis/pericarditis

  Painful recurrences of acute pericarditis may respond to NSAIDs and/or colchicine 0.5 mg orally twice a day for 6 to 12 months with a gradual taper. […] In postpericardiotomy syndrome, post-MI syndrome, or idiopathic pericarditis, antibiotics are not indicated. An NSAID at full doses may control pain and effusion. […] For pericarditis due to rheumatic fever, another systemic rheumatic disease, or tumor, therapy is directed at the underlying process. […] For pericardial effusion due to trauma, surgery is sometimes required to repair the injury and remove blood from the pericardium. […] Patients with symptomatic constrictive pericarditis (eg, with dyspnea, unexplained weight gain, a new or increased pleural effusion, or ascites) and those with markers of chronic constriction (eg, cachexia, atrial fibrillation, hepatic dysfunction, pericardial calcification) usually require pericardial resection.

• #1 Postpericardiotomy Syndrome Treatment & Management: Medical Care, Surgical Care, Prevention

  https://emedicine.medscape.com/article/891471-treatment

  Medical management includes the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, which is given for 4-6 weeks and is tapered as the fluid decreases. For patients not responsive to aspirin, ibuprofen or naproxen may be used. Corticosteroids such as prednisone may be administered for 1 week if NSAIDs fail, followed by a 4-week tapering to avoid early recurrences. […] Colchicine, an anti-gout agent was found to be effective in the treatment of pericarditis and post pericardiotomy syndrome in adults. […] Pediatric reports have described successful treatment of recurrent pericardial effusion achieved with high-dose of intravenous immunoglobulin, as well as with a low weekly dose of methotrexate. […] Anakinra, a recombinant IL-1 receptor antagonist and colchicine have been associated with a decreased recurrence in pericarditis in pediatric patients.

• #1 Management of acute pericarditis: treatment and follow-up

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Management-of-acute-pericarditis-treatment-and-follow-up

  The management of TB pericarditis includes a couple of steps. Tuberculosis not endemic in the population requires systematic investigation and fails to yield a diagnosis of TB pericarditis. In this case, there is no justification for starting anti-TB treatment empirically. In endemic areas, empiric anti-TB chemotherapy is recommended for exudative pericardial effusion after excluding other causes such as malignancy, uraemia, trauma, purulent pericarditis, and autoimmune diseases. […] The treatment is especially targeted to the control of systemic disease. The insignificant response to colchicine and the need for adjunctive immunosuppressive agents are clues to the possible presence of autoinflammatory disease. In some of these conditions, anti-IL or anti-TNF agents may be considered. […] Initial management of acute pericarditis should be focused on screening for specific causes which will determine the choice of therapy. Hospital admission is recommended for high-risk patients with acute pericarditis. Colchicine use is a first-line therapy for acute pericarditis as an adjunct to aspirin/NSAIDs therapy for three months. Corticosteroids are not recommended as first-line therapy for acute pericarditis as they appear to encourage recurrences. Serum CRP should be considered to guide the treatment length and assess the response to therapy. Evaluation of response to anti-inflammatory therapy is recommended after one week.

• #1 Management of acute pericarditis: treatment and follow-up

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Management-of-acute-pericarditis-treatment-and-follow-up

  Acute pericarditis is a self-limiting disease without significant complications or recurrences in 70% to 90% of patients. If the laboratory data support the clinical diagnosis, symptomatic treatment with aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) with gastroprotection should be initiated. Colchicine is recommended first-line therapy as an adjunct to aspirin/NSAIDs. Low-dose corticosteroids should be considered in cases of contraindications/failure of aspirin/NSAIDs and colchicine, and when an infectious cause has been excluded, or when there is a specific indication such as autoimmune disease. Serum CRP guides the treatment length and response to therapy. […] The first non-pharmacological recommendation is to restrict physical activity to no more than is usual for patients not involved in competitive sports until symptoms have been resolved and the diagnostic tests normalised (i.e. CRP, ECG and echocardiogram).

• #1 Understanding Dressler’s Syndrome: Causes, Symptoms & Treatment – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/understanding-dresslers-syndrome-causes-symptoms-treatment/

  Rest: Adequate rest is essential for recovery. It helps ease the strain on your heart and alleviates the symptoms of Dressler’s syndrome. […] Hydration: Staying well-hydrated supports your overall health and aids in the recovery process from post-myocardial infarction syndrome. […] Healthy Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can strengthen your immune system and promote healing by reducing inflammation after a heart attack. […] Stress Management: Reducing stress through relaxation techniques such as deep breathing, meditation, or yoga can help minimize the severity of symptoms associated with autoimmune pericarditis. […] While these home remedies can complement your medical treatment, they should never replace professional care. If you experience persistent chest pain, shortness of breath, or other concerning symptoms of Dressler’s syndrome, seek medical attention without delay. […] Medications like NSAIDs, colchicine, and corticosteroids are central to managing symptoms, while lifestyle changes and home remedies can support your recovery and overall well-being.

• #1 Expert Dressler’s Syndrome Relief with Functional Medicine

  https://winitclinic.com/conditions/dresslers-syndrome-treatment/

  Preventing Dresslers syndrome is challenging, as its occurrence is closely linked to uncontrollable events like heart attacks and surgeries. However, early intervention and treatment can mitigate symptoms and reduce the risk of complications. Natural and functional medicine emphasizes a holistic approach—addressing not just the symptoms but the underlying immune response and overall heart health. Natural treatment options can include: – Anti-inflammatory diet: Consuming foods high in omega-3 fatty acids, antioxidants, and phytonutrients can help reduce inflammation. – Supplements: Fish oil, vitamin D, and curcumin have been noted for their anti-inflammatory properties. However, consulting with a healthcare professional before starting any new supplement is vital. – Stress management: Techniques such as yoga, meditation, and deep breathing can help reduce stress, which may in turn decrease the body’s inflammatory response. – Physical therapy: Gentle exercises, under the guidance of a professional, can improve cardiovascular health without putting undue stress on the heart.

• #1 Dressler’s Syndrome: Causes, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17947-dresslers-syndrome

  Your healthcare provider can treat Dresslers syndrome with medications. […] Anti-inflammatory drugs can reduce your pain and inflammation. The main treatment is usually either aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. […] If you cant take aspirin or NSAIDs or they arent working, your provider may prescribe: […] You may need surgery if: […] If you have a bad case of Dresslers syndrome, your healthcare provider may do a surgical procedure called a pericardiocentesis. […] Total treatment time is typically four to six weeks. […] With early diagnosis and treatment, your prognosis is good. However, for 10% to 15% of people, Dresslers syndrome will come back. […] Be sure to keep taking the medicines your healthcare provider prescribed and follow the instructions they gave you.

• #1 Dressler’s syndrome – WikEM

  https://wikem.org/wiki/Dressler%27s_syndrome

  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: 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: 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 […] Colchicine: may be used in conjunction with NSAIDs […] Glucocorticoids: can be used for refractory Dressler’s syndrome […] […] […] 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.

• #1 The Use of Colchicine in Pericardial Diseases

  https://www.acc.org/Latest-in-Cardiology/Articles/2019/12/04/08/22/The-Use-of-Colchicine-in-Pericardial-Diseases

  Colchicine has since been the focus of many observational and randomized studies for pericardial diseases. […] In fact, it is now a class IA medication to treat acute and recurrent pericarditis. […] The mainstay of treatment is anti-inflammatory medications including NSAIDS in combination with colchicine. The current iteration of guidelines set forth by the European Society of Cardiology (ESC) and currently endorsed by the American College of Cardiology for the diagnosis and management of pericardial diseases recommends 3 months of colchicine for a first occurrence of acute pericarditis. […] As such, colchicine is currently recommended for all patients who have a first episode for pericarditis for a duration of 3 months. […] The 2015 ESC guidelines recommend colchicine for 6 months in recurrent pericarditis with level IA recommendation and is based on three important randomized trials including: COlchicine for REcurrent pericarditis (CORE), COlchicine for Recurrent Pericarditis (CORP) and efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP-2), once again orchestrated by Dr. Imazio and his team.

• #1 Management of acute pericarditis: treatment and follow-up

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Management-of-acute-pericarditis-treatment-and-follow-up

  Poorly responding patients have typically been treated with short courses of corticosteroids. Corticosteroids should be considered as a second option in patients with contraindications and failure of aspirin or NSAIDs because of the risk of favouring the chronic evolution of the disease and promoting drug dependence. In this case they are used with colchicine. However, corticosteroids should be avoided as they appear to encourage recurrences. […] The task force suggests that the term 'acute’ should be adopted for new-onset pericarditis, 'incessant’ for pericarditis with symptoms persisting for four to six weeks, and 'chronic’ for pericarditis lasting more than three months. Recurrent pericarditis is diagnosed with a documented first episode of acute pericarditis, a symptom-free interval of four to six weeks or longer and evidence of subsequent recurrence of pericarditis. Aspirin or NSAIDs remain the mainstay of therapy. Colchicine is recommended on top of standard anti-inflammatory therapy, without a loading dose and using weight-adjusted doses. In cases of incomplete response to aspirin/NSAIDs and colchicine, corticosteroids may be used, but they should be added at low-to-moderate doses to aspirin/NSAIDs and colchicine as triple therapy.

• #2 Dressler’s syndrome – wikidoc

  https://www.wikidoc.org/index.php/Dressler%27s_syndrome

  Dressler’s syndrome is typically treated with high dose (up to 650 mg PO q 4 to 6 hours) enteric-coated aspirin. Acetaminophen can be added for pain management as this does not affect the coagulation system. Anticoagulants should be discontinued if the patient develops a pericardial effusion. […] Anti-inflammatory therapy is recommended in post-STEMI pericarditis as in post-cardiac injury pericardial syndromes for symptom relief and reduction of recurrences. Aspirin is recommended as first choice of anti-inflammatory therapy post-STEMI at a dose of 500-1000 mg every 6-8 h for 12 weeks, decreasing the total daily dose by 250-500 mg every 12 weeks in keeping with 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Colchicine is recommended as first-line therapy as an adjunct to aspirin/non-steroidal anti-inflammatory drug therapy (3 months) and is also recommended for the recurrent forms (6 months).

• #2 Dressler syndrome | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/dressler-syndrome

  The goals of treatment for Dressler syndrome are to manage pain and lower the inflammation. Treatment may involve medicines. Surgery may be needed if complications happen. […] The main treatment for Dressler syndrome is medicine to lower inflammation, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as: Aspirin, Ibuprofen (Advil, Motrin IB, others), Colchicine (Colcrys, Gloperba, others). […] If Dressler syndrome happens after a heart attack, usually aspirin is preferred over other NSAIDs. […] Indomethacin also may be given. […] If those medicines don’t help, the next step might be corticosteroids. These can lower inflammation linked with Dressler syndrome by turning down the immune system. […] Corticosteroids can have serious side effects. And they might interfere with the healing of damaged heart tissue after a heart attack or surgery. For those reasons, corticosteroids tend to be used only when other treatments don’t work.

• #2 Dressler syndrome // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/dressler-syndrome

  The goals of treatment for Dressler syndrome are to manage pain and reduce inflammation. Treatment may involve medications and, if complications occur, surgery. […] The main treatment for Dressler syndrome is medication to reduce inflammation, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as: Aspirin, Ibuprofen (Advil, Motrin IB, others), Colchicine (Colcrys, Gloperba, Mitgare). […] If Dressler syndrome occurs after a heart attack, usually aspirin is preferred over other NSAIDs. […] Indomethacin also may be given. […] If those medications don’t help, the next step might be corticosteroids. These powerful immune system suppressants can reduce inflammation related to Dressler syndrome. […] Corticosteroids can have serious side effects and might interfere with the healing of damaged heart tissue after a heart attack or surgery. For those reasons, corticosteroids are generally used only when other treatments don’t work.

• #2 Dressler’s Syndrome | Doctor

  https://patient.info/doctor/dresslers-syndrome

  Aspirin may be given in large doses, 750-1000 mg eight-hourly for two weeks before tapering down. Monitoring of renal and cardiac function, and consideration of co-prescription of proton pump inhibitors (PPIs), are recommended. […] Other non-steroidal anti-inflammatory drugs (NSAIDs) are used in some cases, or corticosteroids may be used if symptoms are refractory or recurrent, or if NSAIDs are contra-indicated. Steroids are particularly valuable where severe symptoms have required pericardiocentesis, and when infection has been excluded. […] Colchicine in addition to NSAID helps to prevent recurrence and improve response, or may be useful when aspirin is contra-indicated. […] If there is significant pericardial effusion then pericardiocentesis, involving aspiration of the fluid, may be required to relieve the constriction on the heart.

• #2 The Use of Colchicine in Pericardial Diseases

  https://www.acc.org/Latest-in-Cardiology/Articles/2019/12/04/08/22/The-Use-of-Colchicine-in-Pericardial-Diseases

  Colchicine has since been the focus of many observational and randomized studies for pericardial diseases. […] In fact, it is now a class IA medication to treat acute and recurrent pericarditis. […] The mainstay of treatment is anti-inflammatory medications including NSAIDS in combination with colchicine. The current iteration of guidelines set forth by the European Society of Cardiology (ESC) and currently endorsed by the American College of Cardiology for the diagnosis and management of pericardial diseases recommends 3 months of colchicine for a first occurrence of acute pericarditis. […] As such, colchicine is currently recommended for all patients who have a first episode for pericarditis for a duration of 3 months. […] The 2015 ESC guidelines recommend colchicine for 6 months in recurrent pericarditis with level IA recommendation and is based on three important randomized trials including: COlchicine for REcurrent pericarditis (CORE), COlchicine for Recurrent Pericarditis (CORP) and efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP-2), once again orchestrated by Dr. Imazio and his team.

• #2 Dressler Syndrome: Causes, Symptoms, Treatments, and More

  https://resources.healthgrades.com/right-care/heart-health/dressler-syndrome

  Treatment for Dressler syndrome typically involves the use of high dose aspirin. The aspirin course can last up to 4 weeks before tapering to a maintenance dose. […] If aspirin is ineffective in reducing inflammation and decreasing the amount of pericardial fluid around the heart, doctors may prescribe corticosteroids such as prednisone (Rayos, Deltasone). […] Colchicine (Colcrys), an anti-inflammatory medication, can be used to treat acute pericarditis. A 2020 study suggested that the drug may help specifically treat Dressler syndrome in conjunction with acetaminophen. However, more research is needed to determine how it may fit into a treatment regimen for the condition. […] People with severe Dressler’s syndrome may need hospitalization to undergo pericardial drainage and intensive anti-inflammatory therapy. […] Doctors typically diagnose Dressler syndrome through imaging and blood tests. Treatment involves anti-inflammatory medications and pericardial drainage when necessary.

• #2 Post-cardiac injury syndrome: aetiology, diagnosis, and treatment

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Post-cardiac-injury-syndrome-aetiology-diagnosis-and-treatment

  Glucocorticoid administration is required for a minority of patients with contraindications for aspirin and NSAIDs or in case of refractory symptoms. Data for PCIS are lacking, but best clinical practice suggests similar dosing to that administered in pericarditis, e.g., 0.25 to 0.5 mg/kg/d. If steroids are used, it is of the upmost importance to taper dosages very slowly to avoid recurrences. In patients treated with steroids and NSAID/colchicine, steroids must be tapered before colchicine is stopped. […] In our opinion, the best standard of care includes: colchicine for prevention of PPS, aspirin in combination with colchicine for initial treatment, and glucocorticoids for recurrence or contraindications to aspirin. Proton pump inhibitors are required in combination with aspirin.

• #2 Management of acute pericarditis: treatment and follow-up

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Management-of-acute-pericarditis-treatment-and-follow-up

  Poorly responding patients have typically been treated with short courses of corticosteroids. Corticosteroids should be considered as a second option in patients with contraindications and failure of aspirin or NSAIDs because of the risk of favouring the chronic evolution of the disease and promoting drug dependence. In this case they are used with colchicine. However, corticosteroids should be avoided as they appear to encourage recurrences. […] The task force suggests that the term 'acute’ should be adopted for new-onset pericarditis, 'incessant’ for pericarditis with symptoms persisting for four to six weeks, and 'chronic’ for pericarditis lasting more than three months. Recurrent pericarditis is diagnosed with a documented first episode of acute pericarditis, a symptom-free interval of four to six weeks or longer and evidence of subsequent recurrence of pericarditis. Aspirin or NSAIDs remain the mainstay of therapy. Colchicine is recommended on top of standard anti-inflammatory therapy, without a loading dose and using weight-adjusted doses. In cases of incomplete response to aspirin/NSAIDs and colchicine, corticosteroids may be used, but they should be added at low-to-moderate doses to aspirin/NSAIDs and colchicine as triple therapy.

• #2 Acute Pericarditis Treatment: Update on Colchicine

  https://www.uspharmacist.com/article/acute-pericarditis-treatment-update-on-colchicine

  Aspirin and other nonsteroidal anti-inflammatory drugs, prednisone, and colchicine are the mainstays of therapy. […] Strong evidence has emerged for the use of colchicine to treat and prevent recurrent pericarditis. […] NSAID therapy is initiated empirically for idiopathic pericarditis and generally leads to symptom resolution within 2 weeks. […] In the case of Dressler syndrome, high-dose (HD) aspirin is preferred. […] Corticosteroid therapy has resulted in rapid symptom control; however, it has been linked to higher rates of recurrent pericarditis. […] In Dressler syndrome, corticosteroids should be reserved only for refractory symptoms, because these agents can delay myocardial healing. […] Colchicine is an anti-inflammatory agent that works by inhibiting tubulin polymerization, thereby interfering with migration and phagocytosis and reducing the inflammatory cycle.

• #2 Dressler Syndrome: Causes, Diagnosis, and Treatment

  https://www.healthline.com/health/dressler-syndrome

  If you develop any complications of Dressler syndrome, more aggressive treatments may be needed: Pleural effusion is treated by draining the fluid from the lungs with a needle. The procedure is called a thoracentesis. Cardiac tamponade is treated with a procedure called pericardiocentesis. During this procedure, a needle or catheter is used to remove excess fluid. Constrictive pericarditis may be treated with surgery to remove the pericardium (pericardiectomy).

• #2 Dressler Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20700

  Most patients with suspected Dressler syndrome are treated in an outpatient setting with close follow-up unless the patient is hemodynamically unstable. The approach typically involves NSAIDs (e.g., aspirin, ibuprofen, naproxen) tapered over 4 to 6 weeks as the accumulated pericardial fluid diminishes. Patients who do not respond to NSAID therapy may be given a course of corticosteroids (e.g., prednisone) tapered over a 4-week period. Another potential treatment option is colchicine. Some studies suggest that taking this drug before cardiac procedures may reduce the risk of Dressler syndrome; its effectiveness, once Dressler syndrome has developed, is unclear. […] More severe cases of Dressler syndrome (i.e., symptoms that may indicate imminent cardiac tamponade or constrictive pericarditis) may require inpatient care involving pericardial drainage. Pericardiocentesis with subsequent catheter drainage (generally 24 to 48 hours) and concomitant initiation of anti-inflammatory treatment is considered the standard of care for patients with a significant pericardial effusion. If the effusion is global (surrounding the entire heart) and visible anteriorly (in front of the right ventricle), the subxiphoid approach for pericardiocentesis is recommended in addition to echocardiographic guidance.

• #2 Dressler syndrome // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/dressler-syndrome

  Complications of Dressler syndrome can require more-invasive treatments, including: Draining excess fluids. For cardiac tamponade, treatment might be a procedure (pericardiocentesis) in which a needle or small tube (catheter) is used to remove the excess fluid. The procedure is usually done using a local anesthetic. […] Removing the pericardium. For constrictive pericarditis, treatment might involve surgery to remove the pericardium (pericardiectomy).

• #2 Post-cardiac injury syndrome in the Emergency Department: mini-review

  https://www.immunologyresearchjournal.com/articles/postcardiac-injury-syndrome-in-the-emergency-department-minireview.html

  Moreover, therapeutic thoracentesis may be considered in moderate to large pleural effusions to improve respiratory symptoms. […] Most patients respond satisfactorily to the combination of a NSAID and colchicine. Corticosteroids can be considered when NSAIDs are contraindicated or ineffective. The post-operative use of colchicine may also prevent the development of PCIS in patients undergoing cardiac surgery. Since pleural involvement is frequent, therapeutic thoracentesis may be considered in order to hasten resolution of symptoms in moderate to large pleural effusions.

• #2 Dressler Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20700

  Recurrence of post-pericardiotomy syndrome, including Dressler syndrome, is common, and relapses have been reported up to 1 year following the initial event. Some suggest that intravenous immunoglobulin therapy has some benefits in refractory cases, especially in children. Clinicians should remember that the number one risk factor for developing Dressler syndrome is having had it before.

• #2 Postpericardiotomy Syndrome Treatment & Management: Medical Care, Surgical Care, Prevention

  https://emedicine.medscape.com/article/891471-treatment

  Medical management includes the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, which is given for 4-6 weeks and is tapered as the fluid decreases. For patients not responsive to aspirin, ibuprofen or naproxen may be used. Corticosteroids such as prednisone may be administered for 1 week if NSAIDs fail, followed by a 4-week tapering to avoid early recurrences. […] Colchicine, an anti-gout agent was found to be effective in the treatment of pericarditis and post pericardiotomy syndrome in adults. […] Pediatric reports have described successful treatment of recurrent pericardial effusion achieved with high-dose of intravenous immunoglobulin, as well as with a low weekly dose of methotrexate. […] Anakinra, a recombinant IL-1 receptor antagonist and colchicine have been associated with a decreased recurrence in pericarditis in pediatric patients.

• #2 Expert Dressler’s Syndrome Relief with Functional Medicine

  https://winitclinic.com/conditions/dresslers-syndrome-treatment/

  These natural approaches, coupled with conventional treatments such as pain relievers and anti-inflammatory medications prescribed by a healthcare provider, form a comprehensive strategy for managing Dresslers syndrome. It’s always essential to consult with a healthcare professional experienced in both functional and conventional medicine to tailor a treatment plan suited to your individual health needs and conditions.

• #2 Management of acute pericarditis: treatment and follow-up

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Management-of-acute-pericarditis-treatment-and-follow-up

  The management of TB pericarditis includes a couple of steps. Tuberculosis not endemic in the population requires systematic investigation and fails to yield a diagnosis of TB pericarditis. In this case, there is no justification for starting anti-TB treatment empirically. In endemic areas, empiric anti-TB chemotherapy is recommended for exudative pericardial effusion after excluding other causes such as malignancy, uraemia, trauma, purulent pericarditis, and autoimmune diseases. […] The treatment is especially targeted to the control of systemic disease. The insignificant response to colchicine and the need for adjunctive immunosuppressive agents are clues to the possible presence of autoinflammatory disease. In some of these conditions, anti-IL or anti-TNF agents may be considered. […] Initial management of acute pericarditis should be focused on screening for specific causes which will determine the choice of therapy. Hospital admission is recommended for high-risk patients with acute pericarditis. Colchicine use is a first-line therapy for acute pericarditis as an adjunct to aspirin/NSAIDs therapy for three months. Corticosteroids are not recommended as first-line therapy for acute pericarditis as they appear to encourage recurrences. Serum CRP should be considered to guide the treatment length and assess the response to therapy. Evaluation of response to anti-inflammatory therapy is recommended after one week.

• #2 Dressler Syndrome on the Electrocardiogram

  https://en.my-ekg.com/diseases/dressler-syndrome.html

  Anti-inflammatory therapy is recommended in post-STEMI pericarditis as in post-cardiac injury pericardial syndromes for symptom relief and reduction of recurrences. Aspirin is recommended as first choice of anti-inflammatory therapy post-STEMI at a dose of 5001000 mg every 68 hours for 12 weeks, decreasing the total daily dose by 250500 mg every 12 weeks. Colchicine is recommended as first-line therapy as an adjunct to aspirin/non-steroidal anti-inflammatory drug therapy for 3 months. It is also recommended for the recurrent forms (6 months). Corticosteroids are not recommended due to the risk of scar thinning with aneurysm development or rupture. Although pericarditis is not an absolute contraindication to anticoagulation, caution should be exercised because of the potential for hemorrhagic conversion. Pericardiocentesis is rarely required, except for cases of haemodynamic compromise with signs of tamponade.

• #2 Dressler syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dresslers-syndrome/diagnosis-treatment/drc-20371815

  Other treatments may be needed to treat complications of Dressler syndrome. These include: Draining excess fluids. For cardiac tamponade, the excess fluid can be removed with a needle or a small tube called a catheter. This treatment is called pericardiocentesis. It’s usually done using medicine called a local anesthetic that numbs a specific part of the body. […] Removing the pericardium. For constrictive pericarditis, treatment might involve surgery to remove the pericardium. The surgery is called pericardiectomy.

• #2 Dressler syndrome: a literature review | Journal of MEDICAL SCIENCES

  https://medicsciences.com/dressler-syndrome-a-literature-review/

  DS can be diagnosed if two of the five diagnostic criteria are present (fever without other alternative causes, pericardial or pleural pain, pericardial or pleural effusion, fluid in pericardium or pleura, and/or increased C-reactive protein). […] The first-line treatment is non-steroidal anti-inflammatory drugs in combination with colchicine. In treatment-resistant DS, glucocorticoids are given without discontinuing colchicine. If recovery is not achieved even with second-line treatment, immunomodulators or intravenous immunoglobulin are prescribed, and as a last resort, pericardiectomy is performed. […] DS has favorable prognosis if diagnosed in time, but there is a possibility of recurrence of the syndrome (colchicine is an approved medication for prevention).

• #3 Dressler’s Syndrome | Doctor

  https://patient.info/doctor/dresslers-syndrome

  Aspirin may be given in large doses, 750-1000 mg eight-hourly for two weeks before tapering down. Monitoring of renal and cardiac function, and consideration of co-prescription of proton pump inhibitors (PPIs), are recommended. […] Other non-steroidal anti-inflammatory drugs (NSAIDs) are used in some cases, or corticosteroids may be used if symptoms are refractory or recurrent, or if NSAIDs are contra-indicated. Steroids are particularly valuable where severe symptoms have required pericardiocentesis, and when infection has been excluded. […] Colchicine in addition to NSAID helps to prevent recurrence and improve response, or may be useful when aspirin is contra-indicated. […] If there is significant pericardial effusion then pericardiocentesis, involving aspiration of the fluid, may be required to relieve the constriction on the heart.

• #3 Dressler Syndrome on the Electrocardiogram

  https://en.my-ekg.com/diseases/dressler-syndrome.html

  Anti-inflammatory therapy is recommended in post-STEMI pericarditis as in post-cardiac injury pericardial syndromes for symptom relief and reduction of recurrences. Aspirin is recommended as first choice of anti-inflammatory therapy post-STEMI at a dose of 5001000 mg every 68 hours for 12 weeks, decreasing the total daily dose by 250500 mg every 12 weeks. Colchicine is recommended as first-line therapy as an adjunct to aspirin/non-steroidal anti-inflammatory drug therapy for 3 months. It is also recommended for the recurrent forms (6 months). Corticosteroids are not recommended due to the risk of scar thinning with aneurysm development or rupture. Although pericarditis is not an absolute contraindication to anticoagulation, caution should be exercised because of the potential for hemorrhagic conversion. Pericardiocentesis is rarely required, except for cases of haemodynamic compromise with signs of tamponade.

• #3 Dressler syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Dressler_syndrome

  The treatment of Dressler syndrome is managed with NSAIDs such as aspirin, naproxen, and ibuprofen. […] Unless a patient is hemodynamically unstable, management is done in an outpatient setting (e.g. a clinic/office). […] In some resistant cases, corticosteroids can be used but are not preferred (avoided) in the first month due to the high frequency of impaired ventricular healing leading to an increased rate of ventricular rupture. […] Some sources suggest that taking colchicine soon after surgery may help prevent Dressler syndrome.

• #3 Dressler’s syndrome: Causes, symptoms, and treatments

  https://www.medicalnewstoday.com/articles/dresslers-syndrome

  People with Dresslers syndrome only need to stay in the hospital if complications affect how the heart works. Most of those with these syndromes can take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or aspirin, for 4 to 6 weeks while the fluid buildup reduces. […] If symptoms do not respond to NSAIDs, a doctor may prescribe a course of corticosteroids, such as prednisone, across around 4 weeks. […] More severe Dresslers syndrome that leads to pericardial effusion and cardiac tamponade may require a procedure called pericardiocentesis. This involves extracting the fluid with a large needle under anesthesia. […] If symptoms return, especially in children, a person may receive intravenous immunoglobulin therapy via the veins. This may reduce the immune reaction to the initial heart injury and could be effective in people who do not respond to other treatments. […] Treatment often involves nonsteroidal or steroidal anti-inflammatory medications. However, if complications such as cardiac tamponade or constrictive pericarditis develop, the doctor might consider pericardiocentesis.

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