Dressler's Syndrome

Posted by spdeller @spdeller, Apr 28 3:29pm

On January 10, 2024 I had the removal of a TAVR pig valve that was replaced with a larger 27mm mechanical aortic heart valve, as well as a double bypass around a stent that was put into my coronary artery that failed (became totally stenosed/plugged up with scar tissue/inflammation/some plaque from the TAVR that was done in May 2023. Anyway, I have been suffering with recurrent pleural effusions ever since my surgery on January 10. I have had to have a thoracentesis done every 2-3 weeks to drain out over 1200 mLs of fluid. I get SOB on exertion, fluid retention, (which has caused stasis dermatitis, which is quite painful and irritating to my calf skin on my left calf only), low grade fever ever since surgery, with fatigue. My cardiac surgeon and office cardiologist said the cause for this is "probably" due to excessive inflammation from the surgery and cutting of the intrathoracic/mammary artery to use for one of my bypasses. They also harvested my left radial artery for the second bypass. Long story short: I have felt crummy and hard to breathe with my pleural space filling up constantly. When asking my surgeon/ cardiologist about what is going on and what can be done to STOP the filling up of my left pleural space every 2-3 weeks, the only options for treatment they gave me were: 1. Watch and wait to see if it slows down/stops on its own 2. Have a plerodesis procedure done (which sounds awful and very toxic to me having read about shooting in an irritating substance like talc to totally inflame the pleural space so that it sticks to the chest wall to get rid of the pleural space). I am totally mentally exhausted living with this condition like this after heart surgery, am becoming very concerned about the longevity and quality of my life that hopefully remains. I finally decided to get a "second" opinion from an experienced pulmonologist I knew about downstate. He did an exam with me as a new patient. Then shared that he believes I may have a condition called Dressler's syndrome. I have a lot of the symptoms of this condition. So, he ordered for me to take Naprosyn 600 mg twice a day, along with colchicine 0.6mg twice a day with food to prevent stomach upset and bleeding. I pray that these antiinflammatory medicines with work to put this syndrome into total remission.
So, has anyone else ever heard or educated heart patients about this syndrome? I have read it is more commonly diagnosed in patients who have had a heart attack, but it can occur in patients like me who have had open heart surgery ( the second time for me.) A couple of burning questions for me are: How long should I be taking the prescribed doses of the two meds above, how long before I may be able to tell any difference in how I feel, how long before followup bloodwork/CXR/chest US needs to be done to see if this treatment is working? I am also on lifelong Coumadin now, so I am also concerned about how the Naproxen may increase my INR, which I monitor weekly currently at my clinic. Has anyone else been diagnosed with this Syndrome, and if so, what treatment worked for you for it to go away? Thank you for reading my story and any insights/knowledge you can share with me.

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