La sindrome di Dressler si ritiene sia dovuta a un meccanismo di reazione autoimmune al tessuto pericardico alterato in seguito al coinvolgimento nel processo patologico dell’infarto. Questa forma di pericardite insorge da 1 a 6, o anche 12 settimane, dopo un infarto miocardico transmurale.
Sintomi
La sindrome diDressler si presenta con il classico dolore della pericardite, ed eventualmente della pleurite, insieme a febbre. Compare qualche giorno, settimane o anche mesi dopo l’infarto miocardico o un intervento cardiaco con apertura del pericardio.
Diagnosi
All’auscultazione si possono apprezzare sfregamenti pericardici, che tuttavia sono, spesso fugaci, per cui possono sfuggire. L’ECG può mostrare i segni distintivi della pericardite; in questo caso essi sono più facilmente riconoscibili rispetto alla pericardite epistenocardica, in quanto compaiono quando ormai i segni ECG della lesione ischemica sono regrediti. L’esame diagnostico più importante è costituito dall’ecocardiogramma, che quasi sempre mostra la presenza di un versamento pericardico di variabile entità.
Terapia
Le terapie di riferimento sono farmaci antinfiammatori FANS (in particolare aspirina). I corticosteroidi sono indicati soltanto nelle forme severe.
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