概述

心肌梗死后综合征是包在心脏周围的囊状结构发生的炎症(心包炎)。这种炎症被认为是免疫系统为了应对心脏组织损伤或心脏周围的囊状结构(心包)损伤而造成的。损伤可能是由心脏病发作、手术或创伤性损伤引起的。症状包括可能与心脏病发作时类似的胸部疼痛。

心肌梗死后综合征可能也被称为德雷斯勒综合征、创伤后心包炎、心脏损伤后综合征和心包切开术后综合征。

症状

症状可能在心脏病发作、外科手术或胸部损伤后数周至数月后出现。症状可能包括:

  • 胸部疼痛
  • 发热

何时就诊?

突然或持续的胸部疼痛可能是心脏病发作或其他严重疾病的信号,请寻求急救护理。

病因

专家认为心肌梗死后综合征是由免疫系统对心脏损伤的反应所致。受伤组织会导致身体发送免疫细胞和蛋白质(抗体)来清理和修复受累部位。有时,这种反应会引起心包发炎。

进行某些心脏手术或医疗程序后,可能会出现心肌梗死后综合征。

风险因素

Damage to the heart muscle increases the risk of Dressler syndrome. Some things that cause heart muscle are:

  • Chest injury.
  • Some types of heart surgery.
  • Heart attack.

并发症

导致心肌梗死后综合征的免疫系统反应也可导致肺部周围组织中的积液(胸腔积液)。

极少数情况下,心肌梗死后综合征会引起更严重的并发症,包括:

  • 心脏压塞。心包发炎会导致囊中积聚液体(心包积液)。积液会给心脏施加压力,迫使其更加费力地工作,并降低心脏有效泵血的能力。
  • 缩窄性心包炎。复发性或慢性炎症会导致心包变厚或形成疤痕。瘢痕形成可能降低心脏泵血的能力。

预防

一些研究表明,在心脏手术前服用抗炎药物秋水仙碱(Colcrys、Gloperba、Mitgare),可能有助于预防心肌梗死后综合征。

Aug. 05, 2022

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  3. Hoit BD. Etiology of pericardial disease. https://www.uptodate.com/contents/search. Accessed May 26, 2022.
  4. Bonow RO, et al., eds. Pericardial diseases. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed May 26, 2022.
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心肌梗塞后综合征