Dressler's Syndrome Refractory to High-Dose Aspirin and Colchicine: Next-Step Management

This protocol applies when Dressler's syndrome has not responded adequately to the standard first-line anti-inflammatory regimen and symptom remission has not been achieved.

First-Line Failure Condition

High-dose aspirin, used as the first-choice anti-inflammatory agent in a 5–7-day course together with colchicine, represents the standard initial approach. When this combination fails to achieve remission of pericarditis symptoms, escalation is indicated.

Next-Line Approach — Overview

In refractory cases, the evidence supports a targeted biological approach involving IL-1 antagonists — the complete regimen, selection criteria, and clinical guidance are in the full protocol ›

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/ehaf192

IL-1 antagonists are recommended in patients with refractory PCIS to prevent recurrences and progression to constriction.

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