Aydinalp Alp, Wishniak Alice, van den Akker-Berman Lily, Or Tsafrir, Roguin Nathan
Department of Cardiology, Western Galilee Hospital, Nahariya, Israel.
Isr Med Assoc J. 2002 Mar;4(3):181-3.
Myocardial infarction-associated pericarditis is a common cause of chest pain following MI, its frequency depending on how it is defined.
To investigate the incidence of acute pericarditis and pericardial effusion in the acute phase of ST-elevation MI treated with thrombolytic therapy.
The study group comprised 159 consecutive patients fulfilling the criteria for acute MI who were admitted to our department during 18 months. Infarct-associated pericarditis was defined as the finding of a pericardial friction rub, a typical pleuropericardial pain, or both. All patients underwent physical examination of the cardiovascular system four times daily for 7 days, as well as daily electrocardiogram and echo Doppler examinations.
Fourteen patients (8.8%) developed a friction rub and 11 patients (6.9%) had a mild pericardial effusion. Six patients (4.0%) had both a friction rub and pericardial effusion. Two patients had a friction rub for more than 7 days. Pleuropericardial chest pain was present in 31 patients (19.5%) but only 7 of them had a friction rub. The in-hospital mortality rate was 1.3% and no mortality was observed in the acute pericarditis group.
The incidence of signs associated with acute pericarditis was lower in MI patients treated with thrombolysis, compared with historical controls, when a friction rub and/or pericardial effusion was present. There was no significant reduction in the incidence of pleuropericardial chest pain.
心肌梗死相关心包炎是心肌梗死后胸痛的常见原因，其发生率取决于定义方式。
研究溶栓治疗的ST段抬高型心肌梗死急性期急性心包炎和心包积液的发生率。
研究组包括18个月期间连续入住我科的159例符合急性心肌梗死标准的患者。梗死相关心包炎定义为发现心包摩擦音、典型的胸膜心包疼痛或两者皆有。所有患者每天进行4次心血管系统体格检查，持续7天，同时每天进行心电图和超声多普勒检查。
14例患者（8.8%）出现摩擦音，11例患者（6.9%）有轻度心包积液。6例患者（4.0%）既有摩擦音又有心包积液。2例患者摩擦音持续超过7天。31例患者（19.5%）有胸膜心包胸痛，但其中只有7例有摩擦音。住院死亡率为1.3%，急性心包炎组未观察到死亡病例。
与历史对照相比，接受溶栓治疗的心肌梗死患者中，出现摩擦音和/或心包积液时，与急性心包炎相关体征的发生率较低。胸膜心包胸痛的发生率没有显著降低。
