| 词条 | Dressler syndrome |
| 释义 |
| name = Dressler syndrome | image = | caption = | | pronounce = | field = | synonyms = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} 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[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] PresentationDressler syndrome was, historically, a phenomenon complicating about 7% of myocardial infarctions;[7] however, in the era of percutaneous coronary intervention, it is very uncommon. The disease 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, yet nonspecific, laboratory finding. CausesIt 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 which is called postcardiotomy syndrome.{{fact|date=March 2019}} DiagnosisDifferential diagnosisDressler 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.{{fact|date=March 2019}} TreatmentDressler syndrome is best treated with high dose aspirin. In some resistant cases, corticosteroids can be used but are not preferred (avoided) in first month due to the high frequency of impaired ventricular healing leading to increased rate of ventricular rupture. Other 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. Other 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] References1. ^{{cite journal |last1=Hutchcroft |first1=B J |title=Dressler's syndrome |journal=BMJ |date=1 July 1972 |volume=3 |issue=5817 |pages=49–9 |pmid=5039567 |pmc=1788531 |doi=10.1136/bmj.3.5817.49-a }} 2. ^{{cite journal |vauthors=Bendjelid K, Pugin J |title=Is Dressler syndrome dead? |journal=Chest |volume=126 |issue=5 |pages=1680–2 |date=November 2004 |pmid=15539743 |doi=10.1378/chest.126.5.1680 }} 3. ^{{cite journal |vauthors=Streifler J, Pitlik S, Dux S |title=Dressler's syndrome after right ventricular infarction |journal=Postgrad Med J |volume=60 |issue=702 |pages=298–300 |date=April 1984 |pmid=6728756 |pmc=2417818 |doi= 10.1136/pgmj.60.702.298|url=|display-authors=etal}} 4. ^{{cite journal |author=Dressler W |title=The post-myocardial-infarction syndrome: a report on forty-four cases |journal=Arch Intern Med |volume=103 |issue=1 |pages=28–42 |date=January 1959 |pmid=13605300 |doi=10.1001/archinte.1959.00270010034006 }} 5. ^{{WhoNamedIt|synd|3982}} 6. ^{{cite journal |first1=L. A. |last1=Dressler |title=Ein Fall von intermittierender Albuminurie und Chromaturie |trans-title=A case of intermittent albuminuria and chromaturia |language=German |journal=Archiv für Pathologische Anatomie und Physiologie und für Klinische Medizin |year=1854 |volume=6 |pages=264–6 |hdl=2027/hvd.32044093329910 }} 7. ^{{cite journal | doi = 10.1056/NEJM198411083111903 |vauthors=Krainin F, Flessas A, Spodick D | title = Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram | journal = N Engl J Med | volume = 311 | issue = 19 | pages = 1211–4 | year = 1984 | pmid = 6493274}} 8. ^{{cite journal|last=Hertzeanu|first=H|author2=Almog, C |author3=Algom, M |title=Cardiac tamponade in Dressler's syndrome. Case report.|journal=Cardiology|date=1983|volume=70|issue=1|pages=31–6|pmid=6850684|doi=10.1159/000173566}} 9. ^{{cite book |last1=Jaffe |first1=AS |last2=Boyle |first2=AJ |chapter=Acute Myocardial Infarction |pages=51–72 |chapterurl={{Google books|1X5LCtP2_rwC|page=51|plainurl=yes}} |editor1-first=Michael H. |editor1-last=Crawford |title=CURRENT Diagnosis & Treatment: Cardiology |edition=3rd |location=New York |publisher=McGraw-Hill |year=2009 |isbn=978-0-07-170199-0 }} External links{{Medical resources| ICD10 = {{ICD10|I|24|1|i|20}} | ICD9 = {{ICD9|411.0}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | DiseasesDB = 3947 }}{{Circulatory system pathology}}{{DEFAULTSORT:Dressler syndrome}} 1 : Syndromes affecting the heart |
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