| Pericardial involvement during the course of myocardial infarction. A long-term clinical and echocardiographic study. | |
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MedLine Citation:
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PMID: 7606999 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY OBJECTIVE: This study investigated the long-term course of infarct-related pericarditis and pericardial effusion. Focus was given to the following issues: incidence and timing of pericarditis and pericardial effusion during the acute phase and 3 years follow-up, size, hemodynamic and clinical consequences of effusions, and potential risk of thrombolytic or anticoagulant therapy in patients with pericardial effusion. PATIENTS AND STUDY DESIGN: Serial echocardiographic examinations were performed in 192 consecutive patients with first myocardial infarction during the acute phase (day 1, 5, 10, 21) and during 3 years' follow-up (year 1, 2, and 3 after infarction). The follow-up was 100%. Clinical, angiographic, and autopsy data were analyzed. RESULTS: Pericardial effusion was detected at least once during serial echocardiographic examinations in 82 of 192 patients (43%). The incidence in different subgroups (with or without thrombolysis, open or closed artery at 3 weeks, infarction in left anterior descending, left circumflex, or right coronary artery perfusion bed) was similar. Most (48%) effusions were first detected on the fifth day, and most (50%) disappeared between days 21 and 365. However, in nine patients, the effusion persisted beyond 1 year (up to 3 years in three patients). Only systolic separation of pericardial layers was detected in 59% of effusions, circular effusion in 3.6% of all effusions. No cardiac tamponade developed. Heart failure or death complicated 49% of infarctions with pericardial involvement and 16% of infarctions without effusion (p < 0.01). Mortality alone was 8% among patients without effusion and 15% among those with more than minimal effusion (not significant). CONCLUSIONS: Pericardial effusion can be detected by serial echocardiographic examinations in 43% of myocardial infarctions. It appears during the initial 5 days and disappears slowly during several weeks to several months. Anticoagulant and thrombolytic therapy does not increase the frequency or the size of effusions. |
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Authors:
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P Widimský; P Gregor |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Chest Volume: 108 ISSN: 0012-3692 ISO Abbreviation: Chest Publication Date: 1995 Jul |
Date Detail:
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Created Date: 1995-08-17 Completed Date: 1995-08-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 89-93 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine II, University Hospital Vinohrady, Charles University, Prague, Czech Republic. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Clinical Trials as Topic Echocardiography Female Hemodynamics Humans Male Middle Aged Myocardial Infarction / complications*, drug therapy, physiopathology, ultrasonography Pericardial Effusion / etiology*, physiopathology, ultrasonography Pericarditis / etiology*, physiopathology, ultrasonography Prognosis Prospective Studies Stroke Volume Thrombolytic Therapy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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