The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Early-Onset Postcardiac Injury Syndrome after Percutaneous Coronary Intervention Recovered with Steroids

경피적 관상동맥중재술 후 급성으로 발생한 스테로이드 치료로 회복한 심근 손상 후 증후군

  • Kim, Min-Jeong (Division of Cardiology, Department of Internal Medicine, Hongik Hospital) ;
  • Yoon, Seong-Bo (Division of Cardiology, Department of Internal Medicine, Hongik Hospital) ;
  • Lee, Myong Dong (Division of Cardiology, Department of Internal Medicine, Hongik Hospital) ;
  • Kim, Si-Ho (Division of Cardiology, Department of Internal Medicine, Hongik Hospital) ;
  • Kim, Young Woo (Division of Cardiology, Department of Internal Medicine, Hongik Hospital)
  • Received : 2017.07.11
  • Accepted : 2017.09.21
  • Published : 2018.12.01
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Abstract

Postcardiac injury syndrome (PCIS) is an inflammatory process that usually occurs within 1 to 6 weeks after an injury to the pericardium, epicardium, or myocardium. As more interventions are performed for complicated coronary artery obstructive lesions, there have been some recent reports on PCIS following percutaneous coronary intervention (PCI). The medical management of PCIS depends on nonsteroidal anti-inflammatory drugs (NSAIDs), in addition to colchicine or steroids. An 80-year-old male patient underwent a PCI. Unfortunately, the guidewire piercing failed but he showed no immediate signs of complication. However, 5 hours after the procedure, he complained of chest discomfort. An electrocardiogram showed widespread ST elevation. Chest X-ray and computed tomography showed pulmonary congestion with pleural effusion, while thoracic echocardiography showed a moderate amount of pericardial effusion. NSAIDs were initiated, but there was no improvement of symptoms. We describe an unusual case of atypical earl onset PCIS after PCI, recovered rapidly by steroids.

PCIS는 심장 수술, 급성 심근경색 또는 경피적 관상동맥중재술 등에 의하여 발생한 심장 손상 후 발생하는 합병증이다. 본 저자는 경피적 관상동맥중재술 이후 급성으로 발생한 PCIS를 스테로이드를 사용한 약물로 치료하였기에 이를 문헌고찰과 함께 보고하는 바이다. 비스테로이드항염제에 반응하지 않는 PCIS 환자에게 스테로이드의 조기 투약이 도움이 될 수 있고 장기적인 유지 요법이 도움이 될 수 있음을 말해주고 있다.

Keywords

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