ドレスラー症候群
WordNet
- a pattern of symptoms indicative of some disease
- a complex of concurrent things; "every word has a syndrome of meanings"
PrepTutorEJDIC
- (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/01/25 12:39:50」(JST)
[Wiki en表示]
| Dressler's syndrome |
| Classification and external resources |
| ICD-10 |
I24.1 |
| ICD-9 |
411.0 |
| DiseasesDB |
3947 |
Dressler's syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever, pleuritic pain, pericarditis and/or a pericardial effusion.
Dressler's syndrome is also known as postmyocardial infarction syndrome[1] and the term is sometimes used to refer to post-pericardiotomy pericarditis.
It was first characterized by William Dressler at Maimonides Medical Center in 1956.[2][3][4]
It should not be confused with the Dressler's syndrome of haemoglobinuria named for Lucas Dressler, who characterized it in 1854.[5][6]
Contents
- 1 Presentation
- 2 Causes
- 3 Differential diagnosis
- 4 Treatment
- 5 References
- 6 External links
Presentation
Dressler's syndrome occurs in about 7% of myocardial infarctions,[7] and consists of a persistent low-grade fever, chest pain (usually pleuritic in nature), pericarditis (usually evidenced by a pericardial friction rub), and/or a pericardial effusion. The symptoms tend to occur 2–3 weeks after myocardial infarction, but can also be delayed for a few months. It tends to subside in a few days, and very rarely leads to pericardial tamponade.[8] An elevated ESR is an objective laboratory finding.
Causes
It is believed to result from an autoimmune inflammatory reaction to myocardial neo-antigens formed as a result of the MI. A similar pericarditis can be associated with any pericardiotomy or trauma to the pericardium or heart surgery.
Differential diagnosis
Dressler's syndrome needs to be differentiated from pulmonary embolism, another identifiable cause of pleuritic (and non-pleuritic) chest pain in people who have been hospitalized and/or undergone surgical procedures within the preceding weeks.
Treatment
Dressler's syndrome is typically treated with colchicine. In some resistant cases, corticosteroids can be used but are not preferred due to the high frequency of relapse when corticosteroid therapy is discontinued. NSAIDs though once used to treat Dressler syndrome, are less advocated and should be avoided in patients with ischemic heart disease. One NSAID in particular, indomethacin can inhibit new collagen deposition thus impairing the healing process for the infarcted region. NSAIDS should only be used in cases refractory to aspirin. Heparin in Dressler syndrome should be avoided because it can lead to hemorrhage into the pericardial sac leading to tamponade. The only time heparin could be used with pericarditis is with coexisting acute MI in order to prevent further thrombus formation.[9]
References
- ^ Hutchcroft BJ (July 1972). "Dressler's syndrome". Br Med J 3 (5817): 49. doi:10.1136/bmj.3.5817.49-a. PMC 1788531. PMID 5039567.
- ^ Bendjelid K, Pugin J (November 2004). "Is Dressler syndrome dead?". Chest 126 (5): 1680–2. doi:10.1378/chest.126.5.1680. PMID 15539743.
- ^ Streifler J, Pitlik S, Dux S, et al. (April 1984). "Dressler's syndrome after right ventricular infarction". Postgrad Med J 60 (702): 298–300. doi:10.1136/pgmj.60.702.298. PMC 2417818. PMID 6728756.
- ^ Dressler W (January 1959). "The post-myocardial-infarction syndrome: a report on forty-four cases". AMA Arch Intern Med 103 (1): 28–42. doi:10.1001/archinte.1959.00270010034006. PMID 13605300.
- ^ synd/3982 at Who Named It?
- ^ L. A. Dressler. Ein Fall von intermittirender Albuminurie und Chromaturie. Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, 1854, 6: 264-266.
- ^ Krainin F, Flessas A, Spodick D (1984). "Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram". N Engl J Med 311 (19): 1211–4. doi:10.1056/NEJM198411083111903. PMID 6493274.
- ^ Hertzeanu, H; Almog, C; Algom, M (1983). "Cardiac tamponade in Dressler's syndrome. Case report.". Cardiology 70 (1): 31–6. doi:10.1159/000173566. PMID 6850684.
- ^ Jaffe AS, Boyle AJ. Chapter 5. Acute Myocardial Infarction. In: Crawford MH, ed. CURRENT Diagnosis & Treatment: Cardiology. 3rd ed. New York: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=3646487. Accessed June 16, 2012
External links
- -1140457467 at GPnotebook
- For antibody to cardiac muscle
- Dressler's syndrome on CNN
- Cardiovascular disease: heart disease
- Circulatory system pathology
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| Ischaemic |
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Coronary disease
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- Coronary artery disease (CAD)
- Coronary artery aneurysm
- Coronary artery dissection
- Coronary thrombosis
- Coronary vasospasm
- Myocardial bridge
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Active ischemia
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- Angina pectoris
- Prinzmetal's angina
- Stable angina
- Acute coronary syndrome
- Myocardial infarction
- Unstable angina
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Sequelae
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- hours
- Hibernating myocardium
- Myocardial stunning
- days
- weeks
- Aneurysm of heart / Ventricular aneurysm
- Dressler's syndrome
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| Layers |
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Pericardium
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- Pericarditis
- Acute
- Chronic / Constrictive
- Pericardial effusion
- Cardiac tamponade
- Hemopericardium
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Myocardium
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- Myocarditis
- Cardiomyopathy: Dilated (Alcoholic), Hypertrophic, and Restrictive
- Loeffler endocarditis
- Cardiac amyloidosis
- Endocardial fibroelastosis
- Arrhythmogenic right ventricular dysplasia
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Endocardium /
valves
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Endocarditis
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- infective endocarditis
- Subacute bacterial endocarditis
- non-infective endocarditis
- Libman–Sacks endocarditis
- Nonbacterial thrombotic endocarditis
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Valves
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- mitral
- regurgitation
- prolapse
- stenosis
- aortic
- tricuspid
- pulmonary
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Conduction /
arrhythmia |
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Bradycardia
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- Sinus bradycardia
- Sick sinus syndrome
- Heart block: Sinoatrial
- AV
- Intraventricular
- Bundle branch block
- Right
- Left
- Left anterior fascicle
- Left posterior fascicle
- Bifascicular
- Trifascicular
- Adams–Stokes syndrome
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Tachycardia
(paroxysmal and sinus)
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Supraventricular
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- Atrial
- Junctional
- AV nodal reentrant
- Junctional ectopic
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Ventricular
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- Accelerated idioventricular rhythm
- Catecholaminergic polymorphic
- Torsades de pointes
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Premature contraction
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Pre-excitation syndrome
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- Lown–Ganong–Levine
- Wolff–Parkinson–White
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Flutter / fibrillation
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- Atrial flutter
- Ventricular flutter
- Atrial fibrillation
- Ventricular fibrillation
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Pacemaker
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- Ectopic pacemaker / Ectopic beat
- Multifocal atrial tachycardia
- Pacemaker syndrome
- Parasystole
- Wandering pacemaker
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Long QT syndrome
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- Andersen–Tawil
- Jervell and Lange-Nielsen
- Romano–Ward
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Cardiac arrest
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- Sudden cardiac death
- Asystole
- Pulseless electrical activity
- Sinoatrial arrest
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Other / ungrouped
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- hexaxial reference system
- Right axis deviation
- Left axis deviation
- QT
- T
- ST
- Osborn wave
- ST elevation
- ST depression
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| Cardiomegaly |
- Ventricular hypertrophy
- Left
- Right / Cor pulmonale
- Atrial enlargement
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| Other |
- Cardiac fibrosis
- Heart failure
- Diastolic heart failure
- Cardiac asthma
- Rheumatic fever
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| Description |
- Anatomy
- Physiology
- Development
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| Disease |
- Injury
- Congenital
- Neoplasms and cancer
- Other
- Symptoms and signs
- Blood tests
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| Treatment |
- Procedures
- Drugs
- glycosides
- other stimulants
- antiarrhythmics
- vasodilators
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UpToDate Contents
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- 1. 心臓傷害後症候群 post cardiac injury syndromes
- 2. 心臓手術後の胸水 pleural effusions following cardiac surgery
- 3. 心筋梗塞の心膜合併症 pericardial complications of myocardial infarction
- 4. 心膜疾患の病因 etiology of pericardial disease
- 5. 冠動脈バイパス術の早期心合併症 early cardiac complications of coronary artery bypass graft surgery
English Journal
- Extremely high ferritin level after an acute myocardial infarction in an end stage renal disease patient.
- Sandhu G, Mankal P, Gupta I, Tagani A, Ranade A, Jones J, Bansal A.
- Clinical nephrology.Clin Nephrol.2014 Jul;82(1):68-72. doi: 10.5414/CN107696.
- We present here a case of an asymptomatic end-stage renal disease (ESRD) patient, who had an unexplained persistent mild leukocytosis in the setting of an extremely high ferritin level (8,997 ng/ml; reference range: 12 - 300 ng/ml) 3 weeks after she suffered from a myocardial infarction (MI). Infect
- PMID 23211338
- Visualizing pericardial inflammation in Dressler's syndrome with cardiac magnetic resonance imaging.
- Lawley C, Mazhar J, Grieve SM, Figtree GA.
- International journal of cardiology.Int J Cardiol.2013 Sep 20;168(1):e32-3. doi: 10.1016/j.ijcard.2013.05.082. Epub 2013 Jun 14.
- PMID 23769683
- Causes and management of common benign pleural effusions.
- Thomas R1, Lee YC.
- Thoracic surgery clinics.Thorac Surg Clin.2013 Feb;23(1):25-42, v-vi. doi: 10.1016/j.thorsurg.2012.10.004.
- Benign pleural effusions are twice as common as malignant effusions and have diverse causes and manifestations, which often makes them a diagnostic challenge. Differentiating effusions as a transudate or exudate is the first, and often helpful, step in directing investigations for diagnosis and mana
- PMID 23206715
Japanese Journal
- 心筋梗塞後症候群 (冠動脈疾患(下)診断と治療の進歩) -- (心筋梗塞(ST上昇型)の臨床)
- Steroid が著効した Dressler's syndrome の1例(日本循環器学会 第69回九州地方会)
- 中村 夏樹,菊田 浩一,増田 武信,中尾 宏,黒岩 英
- Japanese circulation journal 56(Supplement_III), 978, 1992-07-20
- NAID 110004570588
Related Links
- Dressler's syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of a triad of features: fever, pleuritic pain and pericardial effusion. Dressler's ...
- Dressler's syndrome — Comprehensive overview covers symptoms, treatment of inflammation of the sac surrounding the heart.
Related Pictures
★リンクテーブル★
[★]
- 英
- post-myocardial infarction syndrome, postmyocardial infarction syndrome
- 同
- ドレスラー症候群, Dressler症候群, Dressler's syndrome, Dressler syndrome
- 関
- 心筋梗塞
概念
- 疫学・病因：心臓手術後だけでなく心筋梗塞後や肺塞栓後でも起こり、これらの患者のうちPCISを起こす患者は3.5%であったという報告がある。PCISは歴史的には1956年にDresslerによって急性心筋後、数週間から数ヶ月後に起こると報告されいるが、まれに心筋梗塞後1週間以内に症状が出現することがある。(参考1)
- 病態・症状：胸膜痛(pleuritic chest pain)、胸膜摩擦音、発熱、白血球増多、時に胸水・肺浸浸潤影(pulmonary infiltrate)。(参考1) ← 心筋梗塞後1週間以内に見られる急性心膜炎とは症状や経過が違うらしい。
- 病態生理：免疫性因子の関与が想定されている。心筋障害により心臓由来の抗原が放出され抗体形成を刺激、免疫複合体を形成後に心膜、胸膜、肺に沈着する。免疫複合体に対して炎症反応が惹起されるのが本態とされる。(参考1)
参考
- 1. [charged] Pericardial complications of myocardial infarction - uptodate [1]
[★]
- 英
- fibrinous pericarditis
- 同
- 乾性心膜炎 dry pericarditis、serofibrinous pericarditis
- 関
- [[]]
friction rub
- 尿毒症、全身性エリテマトーデスでfibrinous pericarditisを伴う
- diffuse fibrinous pericarditis is more typical of systemic conditions such as uremia or SLE, whereas focal pericarditis may overlie a transmural MI(Dressler syndrome)
[★]