[Echocardiographic evaluation of pericardial effusion in acute myocardial infarct].

We have assessed the value of M-mode echocardiography in diagnosing the presence and the extent of pericardial effusion after an acute myocardial infarction, in a group of 105 patients. The relations between pericardial effusion and the extent of the infarction, the possible presence of heart failure, the clinical electrocardiographic and radiographic signs of pericarditis have also been investigated. At last we have evaluated the possible influence of the anticoagulant therapy. Our results show a poor (22%) sensitivity of the traditional methods (ECG, X-ray, physical examination) in comparison with echocardiography. This holds true both for the entire group (x2 = 85,8; p less than 0,001), and for the large effusions taken separately (x2 = 59,6; p less than 0,001). A close relation between the area and the extent of myocardial infarction and the presence of pericardial effusion was observed. On the contrary no statistically significant relation between anticoagulant therapy and the extent and frequency of pericardial effusion was found. This type of therapy seems to influence only the duration of pericardial effusion (8,875 +/- 3,1 versus 5,72 +/- 4,9 days). Haemodynamic efficiency is poorly related with the presence of pericardial effusion (X2 = 3 p greater than 0.05). This relation probably depends on the extent of myocardial necrosis. Echocardiographic investigation of the presence and extent of pericardial effusion after myocardial infarction could help to define both the prognosis and the treatment of these patients.