Post-infarction syndrome

Post-infarction syndrome - inflammatory and allergic affection of some agencies (pericardium, pleura, lungs, joints and other)that appear on 2-12 weeks after the occurrence of myocardial infarction. Post-infarction syndrome, apparently, occurs as a reaction to the antibodies produced in dead heart muscle. Typically, post-infarction syndrome is pericarditis with fever. At the same time may occur pleurisy, pneumonia; the latter is often accompanied by hemoptysis. Rarely post-infarction syndrome is isolated polyarthritis. In the study of blood marked leukocytosis, accelerated ROHE, sometimes - eosinophilia. During the post-infarction syndrome - from 1-2 weeks to a few months, because it can recur. The prognosis isgenerally favorable. For the treatment used acetylsalicylic acid, amidopyrine, with severe, recurrent course shown by prescription corticosteroid hormones (cortisone, prednisone).
Cm. also myocardial infarction.

Post-infarction syndrome is a complex of nonspecific inflammatory lesions of the number of bodies (effusion, pleural effusion, pneumonia, arthritis and other)arising on 2-12 weeks, rarely at a later date, after the onset of myocardial infarction regardless of the severity and prevalence, and the usual complications and the causes (heart failure, embolism, infections, and so on).
Typical manifestation of post-infarction syndrome - pericarditis (see), which starts with a very sharp pain in the heart region, aggravated by deep breath and move in a horizontal position; pain iradionet shoulders, epigastric region; temperature increases, increasing the number of white blood cells, accelerates ROHE. Pericarditis is more often exudative, rarely fibrinous. Often joined by the pleurisy, more rarely pneumonias. Sometimes pericardial and pleural exudate has hemorrhagic character. Pneumonia with post-infarction syndrome is usually atypical, often with hemoptysis. P.F. accompanied by tachycardia, ECG on the background of the changes caused by myocardial infarction, there might be changes that are characteristic of pericarditis.
More rare variant of post-infarction syndrome - fever arising in complex with other manifestations of P.F. or in isolation.
The pathogenesis of postinfarction syndrome is not entirely clear. Most authors in favour of allergic nature postinfarction syndrome and believes that it arises as a reaction of the organism during formation in patients with myocardial infarction (see) antibodies to dead heart muscle. Antibodies to the antigen of the heart muscle in myocardial infarction were found Century N. Patentowym, G. A. one of the great and others About allergic mood of patients with myocardial infarction can speak naturally find their increase in the number of eosinophils in 7-12-day sickness, more pronounced in patients with postinfarction syndrome.
During the post-infarction syndrome is prone to relapses over different periods of time.
The prognosis for timely initiation of treatment generally favourable. Without treatment, the possible outcome in adhesive pericarditis.
Post-infarction syndrome is not always detected correctly. Symptoms such as clinical symptoms of pericarditis, tachycardia, fever, leukocytosis, accelerated ROHE, regarded as recurrent or prolonged myocardial infarction, and changes in the lungs, hemoptysis, pleurisy - as heart attack the lungs.
Pericarditis epistenocardica, which have to differentiate pericarditis at P.F., usually occurs in the period between the 2nd and 4th day of illness, quickly disappears, and, as a rule, effusion in the pericardium cavity does not happen, there is no tendency to recurrence.
The differential diagnosis should be borne in mind and idiopathic pericarditis, in the clinical picture of which many similarities with P.F.; however, heart attack is one very quickly abandon the diagnosis of idiopathic pericarditis.
The main principle of treatment of postinfarction syndrome is the application of the desencibiliziruta therapy, mainly steroid hormones, quickly improving the condition of patients. If contraindications to steroid therapy can be recommended the use of acetylsalicylic acid (aspirin). At P.F. proceeding with pericarditis, the use of anticoagulants should be considered contraindicated because of the risk tamponade heart.