Inadvertent administration of streptokinase to patients with pericarditis

Two patients with acute pericarditis who received intravenous streptokinase for presumed acute myocardial infarction are described. Although the administration of streptokinase did not cause an immediate increase in pericardial effusion, delayed nonhemorrhagic pericardial tamponade developed in both. Since pericarditis and other disease entities may mimic the pain and early electrocardiographic manifestations of acute myocardial infarction, precautions should be taken if thrombolytic therapy is given when there are no angiographic data to confirm the myocardial infarction. Pericarditis should be included in the differential diagnosis of patients with chest pain and ST segment elevation for the sake of diagnostic accuracy to avoid inappropriate therapy that may have some inherent risk.