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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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The electrocardiogram often fails to identify pericarditis after percutaneous transluminal coronary angioplasty

J D Slack, C A Pinkerton

    Journal of Electrocardiology
    |October 1, 1986
    PubMed

    Insights

    Acute pericarditis occurred in 6/1,316 patients after percutaneous transluminal coronary angioplasty (PTCA). Dissection at the PTCA site caused localized pericarditis, often presenting atypically without classic ECG changes.

    Area of Science:

    • Cardiology
    • Interventional Cardiology

    Background:

    • Percutaneous transluminal coronary angioplasty (PTCA) is a common procedure for coronary artery disease.
    • Acute pericarditis is a potential complication following cardiac procedures.

    Observation:

    • Six cases of acute pericarditis were identified in 1,316 patients undergoing PTCA.
    • Patients presented with atypical chest pain, low-grade fever, and pericardial friction rub.
    • Cardiac enzymes (CK-MB) were mildly elevated in half of the affected patients.

    Findings:

    • Thallium-201 perfusion imaging showed no perfusion defects.
    • Electrocardiograms (ECG) revealed minor ST-T abnormalities in most patients, with only one showing classical ST elevation.
    • Vessel occlusion or compromise was not observed; significant dissection at the PTCA site was consistently noted.

    Implications:

    • Dissection following PTCA can lead to regional, localized acute pericarditis.
    • Standard ECG may not detect this localized form of pericarditis.
    • Clinical presentation and auscultation are crucial for diagnosing PTCA-associated pericarditis.

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