postmyocardial infarction syndrome

心筋梗塞後症候群

WordNet

1. a pattern of symptoms indicative of some disease
2. a complex of concurrent things; "every word has a syndrome of meanings"

PrepTutorEJDIC

1. (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）』「2015/09/23 08:39:17」(JST)

wiki en

[Wiki en表示]

Dressler syndrome
Classification and external resources
Specialty	cardiology
ICD-10	I24.1
ICD-9-CM	411.0
DiseasesDB	3947

Dressler 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 syndrome is also known as postmyocardial infarction syndrome 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.

It should not be confused with the Dressler's syndrome of haemoglobinuria named for Lucas Dressler, who characterized it in 1854.

Presentation

Dressler syndrome occurs in about 7% of myocardial infarctions, 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. 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 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 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.

References

External links

• -1140457467 at GPnotebook
• For antibody to cardiac muscle
• Dressler's syndrome on CNN

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 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. 突然の心停止および心突然死の概要 overview of sudden cardiac arrest and sudden cardiac death

English Journal

• Insulin Resistance Is Associated With Significant Clinical Atherosclerosis in Nondiabetic Patients With Acute Myocardial Infarction.

• Karrowni W, Li Y, Jones PG, Cresci S, Abdallah MS, Lanfear DE, Maddox TM, McGuire DK, Spertus JA, Horwitz PA.SourceFrom the Division of Cardiovascular Diseases, University of Iowa Carver College of Medicine, Iowa City, IA (W.K., P.A.H.); Saint Luke's Mid America Heart Institute, Kansas City, MO (Y.L., P.G.J., M.S.A., J.A.S.); Washington University, St Louis, MO (S.C.); Henry Ford Hospital, Detroit, MI (D.E.L.); VA Eastern Colorado Health Care System, Denver, CO (T.M.M.); University of Colorado School of Medicine, Denver, CO (T.M.M.); Colorado Cardiovascular Outcomes Research Consortium, Denver, CO (T.M.M.); University of Texas Southwestern Medical Center, Dallas, TX (D.K.M.); and University of Missouri, Kansas City, MO (J.A.S.).
• Arteriosclerosis, thrombosis, and vascular biology.Arterioscler Thromb Vasc Biol.2013 Jul 18. [Epub ahead of print]
• OBJECTIVE: The prevalence of insulin resistance (IR) is increasing worldwide because of increasing age, obesity, and physical inactivity. Emerging evidence supports a direct proatherogenic effect of IR on the coronary vasculature, but the relation between IR and angiographic atherosclerosis in a rea
• PMID 23868937

• [Acute myocardial infarction mimicking takotsubo cardiomyopathy in a patient with myocardial bridging].

• Elikowski W, Małek M, Pyda M, Dziarmaga M, Angerer D, Montewska D.SourceJózef Struś Hospital, Poznan, Poland, Department of Internal Medicine. welikowski@wp.pl
• Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego.Pol Merkur Lekarski.2012 Oct;33(196):202-6.
• The authors present a case of a 70-year-old woman in whom clinical picture of an acute coronary syndrome with ST segment elevation was suggestive of takotsubo cardiomyopathy (TC). Chest pain, extensive ECG changes and typical TC left ventricular contraction pattern were preceded by emotional and phy
• PMID 23272607

• [Bilaterale pneumonia after myocardial infarction].

• Schwarz EI, Giambarba C.SourceInterdisziplinäre Intensivstation, Stadtspital Waid, Zürich.
• Praxis.Praxis (Bern 1994).2012 Aug 8;101(16):1045-9. doi: 10.1024/1661-8157/a001024.
• A 63-year-old man was admitted with fever and bilateral pulmonary infiltrates accompanied by pleural effusion a few days after ST-segment elevation myocardial infarction treated with primary angioplasty and stent implantation. The diagnosis of early postmyocardial infarction syndrome (Dressler's syn
• PMID 22878948

Japanese Journal

• Current incidence of postmyocardial infarction (Dressler's) syndrome.

• LICHSTEIN E.
• Am J Cardiol 50, 1269-1271, 1982
• NAID 30004387036

• Clinical studies of the postmyocardial infarction syndrome

• 宗像 純司
• 日本医科大学雑誌 47(1), 66-79, 1980
• … described the cases having body temperature elevation and chest pain, which developed following acute myocardial infarction, accompanied with pericarditis, pleuritis, pneumonia, acceleration of erythrocyte sedimentation rate, leucocytosis, eosinophilia, etc.and named this condition as postmyocardial infarction syndrome (PMIS).Tendency of recurrence of these symptoms were also noted by Dressler and he suggested that autoimmune mechanism might be responsible for these …
• NAID 130003752683

• 9)心筋硬塞後症候群,左心室瘤形成をみた33歳男子の1症例 : 第40回日本循環器学会九州地方会

• 西 征二,石神 稔郎,福田 正臣,大柿 悟,中村 周治,構内 十郎,平 明
• Japanese circulation journal 42(1), 91, 1978-02-20
• NAID 110002629645

Related Links

• postmyocardial infarction syndrome - definition of ...

postmyocardial infarction syndrome [-mī·əkär′dē·əl] Etymology: L, post + Gk, mys, muscle, kardia, heart; L, infarcire, to stuff a condition that may occur days or weeks after an acute myocardial infarction. It is characterized by chest ...

• Postmyocardial Infarction Syndrome - Circulation

POSTMYOCARDIAL INFARCTION SYNDROME FIG. 2. Case 1. Comparative bedside chest x-rays showing the appearance of pericardial effusion 10 days after admission. a healed anteroseptal myocardial infarction and serial ...

---

★リンクテーブル★

リンク元	「心筋梗塞後症候群」
関連記事	「syndrome」

「心筋梗塞後症候群」

　　[★]

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

• 様々な呼び方がある。(参考1)

• post cardiac injury syndrome PCIS
• Dressler's syndrome
• postpericardiotomy syndrome
• [心筋梗塞後に起こった物について特に]postmyocardial infarction syndrome (Post-MI fibrinous pericarditis)

• 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]

「syndrome」

　　[★]

• n.

• 症候群