Nature and progression of pericardial effusion in patients with a first myocardial infarction: Relationship to age and free wall rupture

Figueras, Jaume; Juncal, Alberto; Carballo, Julio; Cortadellas, Josefa; Soler, Jordi Soler

doi:10.1067/mjh.2002.123840

Cited by 24 publications

(9 citation statements)

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“…Z kolei w CMR można wykazać cechy jednoczesnego procesu zapalnego w osierdziu [179]. Jeżeli po przebytym MI stwierdza się obecność > 10 mm płynu w worku osierdziowym, należy wykonać badania dodatkowe, aby wykluczyć podostre pęknięcie ściany serca [180,181]. Schorzenie ma u większości pacjentów przebieg samoograniczający się, a leczenie ma jedynie charakter podtrzymujący.…”

Section: Pozawałowe Zapalenie Osierdziaunclassified

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

Adler

Charron²,

Imazio³

et al. 2015

Kardiol Pol

202

293

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Section: Pozawałowe Zapalenie Osierdziaunclassified

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

Adler

Charron²,

Imazio³

et al. 2015

Kardiol Pol

202

293

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“…Age was the only variable independently associated with MPE in a previous study with 1149 STEMI patients. 5 …”

Section: Patientsmentioning

confidence: 99%

“…18,19 Unfortunately, this is often not the case; mortality has been steadily high in patients with CTϩEMD, even in the reperfusion era. 3,15,20 -25 Patients with CTw/oEMD, generally considered cases of subacute FWR, 3,5,14,23,26 showed a manifest lower mortality. Indeed, a substantial number of them had prompt hemodynamic recovery with pericardiocentesis, and in contrast to other reports, 3,14,27-29 they were initially managed medically on the basis of a previous positive experience.…”

Section: Management and Outcomementioning

confidence: 99%

“…In the largest series, pericardiocentesis was hemorrhagic in 16 of 26 patients with a hematocrit Ͼ25%, 3 thereby hampering diagnosis of self-limited bleeding with subsequent hemodilution. 5 Sources of MPE in CT patients other than FWR such as heart failure 2,4 or fibrinous pericarditis with bleeding enhanced by anticoagulants or thrombolytic agents 6 -8 could not be ruled out. However, similarities between their clinical, ECG, and angiographic features and those in patients in whom an FWR was documented would suggest a similar mechanism of MPE.…”

Section: Figueras Et Al Pericardial Effusion In Stemi Patientsmentioning

confidence: 99%

“…[1][2][3][4][5] Although it is often associated with left ventricular free-wall rupture (FWR), 3,5 it can also be produced by heart failure, 1,2 myocardial hemorrhage caused by anticoagulant or antiaggregant therapies, 6 -8 or pericarditis. 9 Moreover, in view of the high rate of underlying FWR, CT often requires emergency surgery, 2,5,6 particularly when associated with EMD. 10,11 Pericardiocentesis and blood pressure control may also be life-saving.…”

mentioning

confidence: 99%

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Hospital Outcome of Moderate to Severe Pericardial Effusion Complicating ST-Elevation Acute Myocardial Infarction

et al. 2010

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Background-Hospital prognosis of moderate to severe pericardial effusion (MPE; Ն10 mm) in ST-elevation myocardial infarction is largely unknown. Methods and Results-Data from 446 ST-elevation myocardial infarction patients, 228 with MPE-88 with cardiac tamponade (CT) and electromechanical dissociation (EMD), 44 with CT without EMD (w/oEMD), and 96 without initial CT-and 218 with small PE (5 to 9 mm), were compared. Patients with MPE without initial CT were also compared with 96 patients without PE. CT patients showed larger PE (PϽ0.001) than those without initial CT; 85% of those with CTϩEMD and 86% with CTw/oEMD were treated with pericardiocentesis and 10% and 21% were treated with a surgical repair, respectively. Among MPE patients, 30-day mortality was 43% and was higher in those with CTϩEMD (operated, 89%; and nonoperated, 85%) than in those with CTw/oEMD (22% and 11%, respectively; PϽ0.001) and those without initial CT (17%; PϽ0.001). It was also higher than in patients with small PE (10%; PϽ0.001) or those without PE (6%; Pϭ0.001). Death was attributable to cardiac rupture in 83% of patients with CTϩEMD, 7% with CTw/oEMD, and 8% with MPE without initial CT and occurred late (Ն7 days) in 14%, 67%, and 100%, respectively. Conclusions-MPE carries an increased mortality that is highest in patients with CTϩEMD. In those with CTw/oEMD, however, mortality is considerably low after pericardiocentesis, and subsequent management may be individualized because a conservative approach is often successful. Importantly, MPE patients without initial CT are not free from late rupture and deserve further investigation.

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ST-Segment Elevation Myocardial Infarction

Mohebbi

2022

Practical Cardiology

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Nature and progression of pericardial effusion in patients with a first myocardial infarction: Relationship to age and free wall rupture

Cited by 24 publications

References 0 publications

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

Hospital Outcome of Moderate to Severe Pericardial Effusion Complicating ST-Elevation Acute Myocardial Infarction

ST-Segment Elevation Myocardial Infarction

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