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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

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Frequency and predictors of urgent coronary angiography in patients with acute pericarditis

Adam C Salisbury1, Cristina Olalla-Gómez, Charanjit S Rihal

  • 1Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

Mayo Clinic Proceedings
|January 6, 2009
PubMed

Insights

Urgent coronary angiography is frequently used in acute pericarditis patients, especially with ST-segment elevation. Coronary artery disease was found in one-third of those undergoing the procedure, highlighting the need to differentiate from myocardial infarction.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Diagnostic Imaging

Background:

  • Acute pericarditis is an inflammation of the pericardium.
  • Distinguishing pericarditis from acute coronary syndromes is clinically important.
  • Coronary angiography is a key diagnostic tool for coronary artery disease.

Purpose of the Study:

  • To determine the frequency of urgent coronary angiography in acute pericarditis patients.
  • To identify clinical factors associated with undergoing coronary angiography.
  • To assess the prevalence of coronary artery disease in this cohort.

Main Methods:

  • Retrospective analysis of 238 patients with acute pericarditis (2000-2006).
  • Evaluation of clinical characteristics, electrocardiogram findings, and troponin T values.
  • Analysis of coronary angiography utilization and findings.

Main Results:

  • Coronary angiography was performed in 16.8% of patients.
  • Angiography frequency was 5-fold higher in patients with ST-segment elevation (24.7% vs 4.3%).
  • Typical anginal chest pain, ST-segment elevation, and elevated troponin T were associated with angiography; 35% had coronary artery disease.

Conclusions:

  • Urgent coronary angiography is common in acute pericarditis, particularly with ST-segment elevation and myocardial infarction symptoms.
  • Coronary artery disease is present in about one-third of patients undergoing angiography for suspected cardiac events.
  • Clinicians should consider pericarditis to avoid unnecessary angiography in ST-elevation myocardial infarction patients.
Abstract

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