Center for Internal Medicine, Department of Cardiology and Angiology, University Hospital Magdeburg; Department of Cardiac and Thoracic Surgery, University Hospital Magdeburg; Helios Medical Center Helmstedt, Magdeburg Site.
Dtsch Arztebl Int. 2018 Mar 23;115(12):193-199. doi: 10.3238/arztebl.2018.0193.
Persistent fever of unknown cause is only rarely of cardiac origin, but heart disease must be considered in the differential diagnosis. Aside from endocarditis, pericarditis and various other conditions may be responsible.
This review is based on pertinent articles retrieved by a selective search in PubMed and Google Scholar employing the term "fever" in combination with "myocardial infarction," "pericarditis," "endocarditis," and "postcardiac injury," with additional consideration of current cardiological guidelines.
Endocarditis is associated with fever in 90% of cases, but 25-50% of patients also develop high body temperatures after acute myocardial infarction. In pericarditis, a temperature above 38°C indicates a poorer prognosis; if accompanied by other warning signs, it is an indication for hospitalization and pericardiocentesis. Fever can arise after cardiac surgical procedures as a manifestation of post - cardiotomy syndrome, a special type of perimyocarditis. There may be a latency period of up to 3 months.
Fever can have both infectious and non-infectious cardiac causes. Its interpretation depends on the clinical context. The evidence base for treatment is sparse, and controlled trials are needed.
不明原因的持续性发热很少由心脏原因引起,但在鉴别诊断中必须考虑到心脏病。除了心内膜炎,心包炎和各种其他情况也可能是病因。
本综述基于在 PubMed 和 Google Scholar 中使用“fever”与“myocardial infarction”、“pericarditis”、“endocarditis”和“postcardiac injury”组合进行选择性搜索检索到的相关文章,并考虑了当前的心脏病学指南。
心内膜炎在 90%的病例中与发热有关,但 25-50%的急性心肌梗死后患者也会出现高热。在心包炎中,体温超过 38°C 表明预后较差;如果伴有其他警告信号,则表明需要住院和心包穿刺。在心脏手术后可能会出现发热,表现为心肌切开术后综合征,这是一种特殊类型的心肌炎。潜伏期可达 3 个月。
发热可能有感染性和非感染性的心脏原因。其解释取决于临床情况。治疗的证据基础很少,需要进行对照试验。