FREQUENCY OF PERICARDIAL EFFUSION IN PATIENTS WITH FIRST MYOCARDIAL INFARCTION AND ITS EFFECTS ON IN-HOSPITAL MORBIDITY AND MORTALITY
Abstract
Background: Pericardial effusion (PE) is not an uncommon finding in serial echocardiographicevaluation of patients with AMI, especially when infarction is anterior and extensive. The objectiveof this study was to determine the frequency of pericardial effusion after first myocardial infarctionand its effects on in-hospital morbidity and mortality. Methods: This descriptive study wasperformed in the Department of Cardiology, PGMI, LRH Peshawar, from July 2007 to December2007. Main outcome measure was frequency of pericardial effusion. Results: Out of 200 patientswith first acute myocardial infarction (AMI), mean age was 56±18 (28–90 years). Majority ofpatients (31.5%) were in the age range of 51–60 years. Males were 65.5% and 34.5% were females.Pericardial effusion was found in 4.5% patients on day 0, in 12.5% patients on day 2 and in 15%patients on day 4. Left ventricular failure was documented in 19 (9.5%) patients without and 42(21%) patients with pericardial effusion (p<0.05%). Cardiogenic shock was reported in 5 (2.5%)patients without and 16 (8%) in patients with pericardial effusion and mitral regurgitation was foundin 3 (1.5%) patients in each group. Death was recorded in 1 (0.5%) patient without pericardialeffusion and was 1.5% (n=3) in patients with pericardial effusion. Conclusions: Pericardial effusionwas seen in one third of the patients with first acute myocardial infarction. In acute phase ofmyocardial infarction, the chances of development of pericardial effusion increases as the timepasses. Left ventricular failure was the commonest in-hospital morbidity followed by cardiogenicshock and mitral regurgitation. In-hospital mortality was more in patients with pericardial effusion.Keywords: Myocardial infarction, pericardial effusion, complications, diagnosis, echocardiographyReferences
Malik IA, Mahmood K, Raja K. Acute myocardial infarction.
Professional Med J 2005;12:457–65.
Samad A. Coronary artery disease in Pakistan: preventive aspect.
Pak J Cardiol 2003;14:59–60.
Mozzoni V, Taiti A. Bartoletti A, Monopoli A, Nunziia R. Petix.
The spectrum of pericardial effusion in acute myocardial infarction:
an echocardiographic study. Ital Heart J 2001;1:45–9.
Van de Werf F, Ardissino D, Betriu A, Cokkinos DV, Falk E,
Fox KA, et al. Management of acute myocardial infarction in
patients with ST-segment elevation. Eur Heart J 2003;24:28–86.
Belkin RN, Mark DB, Aronson L, Szwed H, Callif RM, Kisslo J.
Pericardial effusion after intravenous recombinant tissue-type
plasminogen activator for acute myocardial infarction. Am J
Cardiol 1991;67:496–500
Figueras J, Juncal A, Carballo J, Cortadellas J, Soler JS. Nature
and progression of pericardial effusion in patients with a first
myocardial infarction: relationship to age and free wall rupture.
Am Heart J 2002;144:251–8.
Sugiura T, Nakamura S, Kudo Y, Okumya T, Yamasaki F,
Iwasaka T. Clinical factors associated with persistent pericardial
effusion after successful primary coronary angioplasty. Chest
;128:798–803.
Ali Z, Ahmad I, Sheikh SS, Hameed S, Naveed T, Azhar M.
pericardial effusion in acute myocardial infarction: frequency and
in-hospital course. Ann King Edward Med Coll 2006;12:563–5.
Toth C, Csomos M, Vadnav I. Significance of early
echocardiography in acute myocardial infarction. Orv Hetil
;138:787–91.
Sugiura T, Iwasaka T, Tarumi N, Takehana K, Nagahama Y,
Inada M. clinical significance of pericardial effusion in Q-wave
inferior wall acute myocardial infarction. Am J Cardiol
;73:862–4.
Widimsky P, Gregor P. Pericardial involvement during the
course of myocardial infarction: a long-term clinical and
echocardiographic study. Chest 1995;108:89–93.
Gregor P, Widimsky P. Pericardial effusion as a consequence of
acute myocardial infarction. Echocardiography 1999;16:317–20.
Aydinalp A, Wishniak A, van den Akker-Berman L, Or T,
Roguin N. Pericarditis and pericardial effusion in acute STelevation myocardial infarction in the thrombolytic era. Isr Med
Assoc J 2002;4:181–3.
Khan AN, Ambreen F, Qureshi IZ. Hyperglycemia and inhospital outcomes after first myocardial infarction. Rawal Med J
;31:55–7.
Di Bella G, Aquaro GD, Strata E, Deiana M, De Marchi D,
Lombardi M, et al. Simultaneous visualization of myocardial
scar, no-reflow phenomenon, ventricular and atrial thrombi by
cardiac magnetic resonance. Int J Cardiol 2007;115:e10–11.
Nemeth MA, Coulter S, Flamm SD. Pericarditis after myocardial
infarction. Tex Heart Inst J 2003;30:246–7.
Jafar TH, Jafary FH, Jessani S, Chaturvedi N. Heart disease
epidemic in Pakistan: women and men at equal risk. Am Heart J
;150:221–6.
Iqbal MP, Khan AH, Mehboob NA, Iqbal SP. Human
paraoxonase and HDL-cholesterol in Pakistani patients with
acute myocardial infarction and normal healthy adults. Pak J Med
Sci 2007;23:659–64.
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