A Case of Neuroleptic Malignant Syndrome following Open Heart Surgery / 日本心臓血管外科学会雑誌

ABSTRACT

A 57-year-old man who underwent aortic root replacement developed continued to have highgrade fever and rhabdomyolysis after administration of haloperidol on the 10th postoperative day, resulted in deterioration of respiratory and hemodynamic status. We established a diagnosis of neuroleptic malignant syndrome (NMS) incomplete type with difficulty after examination by a psychiatrist, and started administration of dantrolen on postoperative day 17. The serum level of CK rapidly decreased. Because NMS causes severe worsening of general status, early diagnosis and immediate treatment is important particularly after cardiac surgery. Care should be paid to the recognition of causative drugs and status, and symptoms of the early stag, such as muscular rigidity, psychiatric symptoms. It is necessary to investigate medical treatments immediately together with a psychiatrist or neurologist. On the other hand, NMS after heart valve replacements should be distinguished from prosthetic valve endocarditis, and the type of fever and inflammatory reaction can help in differential diagnosis.