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Frequency of pericardial effusion as determined by M-mode echocardiography in acute myocardial infarction
Abstract:
A pericardial friction rub occurs in 6 to 16% of patients after acute myocardial infarction (AMI), but the incidence of pericardial effusion (PE) is not known. M-mode echocardiography was done 1, 3 and 5 days after AMI in 43 consecutive patients admitted within 24 hours of AMI, and PE was detected in 16 (37%). The PE was small in 7 patients, moderate in 6 and large in 3. A pericardial friction rub developed in 8 (19%), of whom only 4 had PE. Pleuritic chest pain diminished by sitting up and relieved by antiinflammatory agents developed in 12 (28%), of whom only 5 had PE. The peak creatine kinase level was significantly higher in patients with PE (1,769 +/- 1,003 U) than in those without (1,181 +/- 838 units). More patients with PE were in Killip classification II, III or IV (11 of 16 [69%] vs 9 of 27 [33%]). The presence of PE was not associated with age, site of AMI, development of Q waves, use of heparin or previous AMI. In conclusion, PE as detected by M-mode echocardiography is frequently present after AMI, and its presence is not closely associated with the occurrence of a pericardial friction rub or typical pericardial pain.
Insights
Pericardial effusion (PE) is common after acute myocardial infarction (AMI), detected in 37% of patients via echocardiography. However, PE presence doesn't strongly correlate with pericardial friction rubs or chest pain.
Area of Science:
- Cardiology
- Internal Medicine
- Diagnostic Imaging
Background:
- Pericardial friction rub is observed in 6-16% of acute myocardial infarction (AMI) patients.
- The incidence and characteristics of pericardial effusion (PE) post-AMI are not well-established.
Purpose of the Study:
- To determine the incidence of pericardial effusion (PE) in patients following acute myocardial infarction (AMI).
- To investigate the association between PE and clinical findings such as pericardial friction rub, chest pain, and cardiac biomarkers.
Main Methods:
- M-mode echocardiography was performed on 43 consecutive AMI patients at 1, 3, and 5 days post-admission.
- Clinical data including pericardial friction rub, chest pain characteristics, peak creatine kinase levels, and Killip classification were collected.
Main Results:
- Pericardial effusion (PE) was detected in 37% (16 of 43) of AMI patients.
- PE was small in 7, moderate in 6, and large in 3 patients.
- Pericardial friction rub occurred in 19% (8 of 43), with only 4 having PE.
- Pleuritic chest pain was present in 28% (12 of 43), with only 5 having PE.
- Patients with PE had significantly higher peak creatine kinase levels and were more likely to be in Killip classification II, III, or IV.
Conclusions:
- Pericardial effusion (PE) is frequently present after acute myocardial infarction (AMI), as detected by echocardiography.
- The presence of PE is not closely associated with the occurrence of a pericardial friction rub or typical pericardial pain.
- PE detection via echocardiography may offer prognostic value, indicated by higher peak creatine kinase levels and more severe heart failure classifications.