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[Pericarditis in recent myocardial infarct]
Insights
Epistenocardial pericarditis, a complication of myocardial infarction, occurred in 16% of patients. Its presence did not increase mortality or acute complications, despite higher atrial fibrillation rates.
Area of Science:
- Cardiology
- Internal Medicine
Context:
- Myocardial infarction (MI) is a leading cause of death and disability worldwide.
- Pericarditis, inflammation of the pericardium, can occur as a complication of MI.
- Epistenocardial pericarditis, specifically, is associated with anterior MI.
Purpose:
- To investigate the incidence and clinical significance of epistenocardial pericarditis in patients with myocardial infarction.
- To assess the impact of epistenocardial pericarditis on mortality, acute complications, and thromboembolic events.
- To evaluate the safety of brief anticoagulant suspension in patients with epistenocardial pericarditis.
Summary:
- Epistenocardial pericarditis was observed in 16% (64/400) of myocardial infarction patients.
- No significant differences in mortality or acute complications (cardiac insufficiency, arrhythmia) were found compared to controls.
- Atrial fibrillation was more frequent in patients with epistenocardial pericarditis, but thromboembolic complications did not increase with brief anticoagulant suspension.
Impact:
- Highlights the relatively benign nature of epistenocardial pericarditis regarding mortality and acute complications.
- Suggests that brief anticoagulant interruption is safe in this patient group, even with increased atrial fibrillation.
- Informs clinical management decisions for myocardial infarction patients who develop pericarditis.
Abstract:
Epistenocardial pericarditis, usually associated with anterior infarct, was noted in 64/400 myocardial infarct subjects admitted to an intensive care unit. No significant difference was observed with respect to this group in the case of mortality (20.6% as opposed to 26.2% in the controls) or complications of the acute stage, such as cardiac insufficiency and arrhythmia, though atrial fibrillation was more frequent (25% as against 15%). In all but one case, anticoagulant management was suspended on the appearance of pericarditis. In spite of the high frequency of atrial fibrillation, thromboembolic complications were not more frequent during brief (48-72 hr) suspension of anticoagulants. Dressler's syndrome was noted in 7 cases (1.7%), with epistenocardial pericarditis (4/7) or ventricular ectasia (3/7). Haemopericardium occurred in the case where anticoagulant management was not suspended.