Int. J. Biosci.15( 6), 441-449, December 2019
Pericardial Effusion (PE) is a complication after acute myocardial infarction (AMI), the objectives of this study was to determine the frequency and severity of PE after AMI and its association with other AMI complications. This cross sectional study was conducted in tertiary care hospital, Peshawar from March to August 2018. A total of 160 patients having AMI were included and data were collected through questionnaire after echocardiography test. PE was considered, if there is echo-free space in between visceral and parietal pericardium, when persist throughout cardiac cycle considered mild if <1cm, moderate 1-2cm and large > 2cm echo-free space. Both gender were included having age 25-85 years while patients with cardiomyopathies, heart failure, malignancy, TB and renal diseases were excluded from this study. All data was analyzed by SPSS-23. Out of 160 patients having AMI, 115 (71.9%) were male and 45 (28.1%) were female with mean age of 56.9±11.6 years. PE was found in 29 (18.1%) patients, mild and moderate PE was in 23 (14.4%) and 6 (3.8%) patients respectively. Majority of patients 82 (51%) were with acute anterior wall MI and no significant association (p > 0.05) were observed between location of AMI and PE. Other AMI complications such as mitral regurgitation, left ventricular dysfunction, LV clot, Ventricular aneurysm and ventricular septal rupture observed more in patients with PE and their association with PE proved statistically significant (p < 0.05). It is concluded that PE is a common complication after AMI and its complications are more in Patients with PE.
Ali Z, Ahmad I, Sheikh S, Hameed S, Naveed T, Azhar M. 2006. Pericardial effusion in acute myocardial infarction: frequency and in-hospital course. Annals of King Edward Medical University 12(4), 563–565.
Ariyarajah V, Spodick DH. 2007. Cardiac Tamponade Revisited: A Postmortem Look at a Cautionary Case. Texas Heart Institute Journal 34, 347–351.
Armstrong WF, Schilt BF, Helper DJ, Dillon JC, Feigenbaum H. 1982. Diastolic collapse of the right ventricle with cardiac tamponade: An Echocardiographic study. Circulation 65, 1491–1496.
Charlap S, Greengart S, Budzilowicz L, Gelbfish J, Hollander G, Shani J. 1989. Pericardial Effusion Early in Acute Myocardial Infarction. Clinical Cardiology 12, 252–254.
Davies MJ, Thomas AC. 1985. Review Plaque fissuring-the cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina. British Heart Journal 53, 363–373.
Davies MJ, Woolf N, Robertson WB. 1976. Pathology of acute myocardial infarction with particular reference to occlusive coronary thrombi. British Heart Journal 38, 659–664.
Galve E, Garcia-Del-Castillo H, Evangelista A, Batlle J, Permanyer MG, Soler-Soler J. 1986. Pericardial effusion in the course of myocardial infarction: incidence, natural history, and clinical relevance. Circulation 73, 294–299.
Gregor P, Widimsky P. 1999. Pericardial Effusion as a Consequence of Acute Myocardial Infarction. Echocardiography 16, 317–320.
Horowitz MS, Schultz CS, Stinson EB, Harrison DC, Popp RL. 1974. Sensitivity and specificity of echocardiographic diagnosis of pericardial effusion. Circulation 50, 239–247.
Imazio M, Adler Y. 2013. Management of pericardial effusion. European Heart Journal 34(16), 1186–1197. http://dx.doi.org/10.1093/eurheartj/ehs372.
Kaplan K, Davison R, Parker M, Przybylek J, Light A, Bresnahan D. 1985. Frequency of pericardial effusion as determined by M-mode echocardiography in acute myocardial infarction. The American Journal of Cardiology 55(4), 335–337.
Lindenberger M, Kjellberg M, Karlsson E, Wranne B. 2003. Pericardiocentesis guided by 2-D echocardiography : the method of choice for treatment of pericardial effusion. Journal of Internal Medicine 253, 411–417.
OH Jk, Seward JB, Tajik AJ. 2006. Pericardial Disease. In The Echo Manual. 3rd edition. New Dehli: Wolter Kluwer, 289–310.
Parameswaran R, Goldberg H. 1983. Echocardiographic Quantitation of Pericardial Effusion. Chest 83, 767–770. http://dx.doi.org/10.1378/chest.83.5.767.
Pate JW, Gardner HC, Norman RS. 1996. Diagnosis of Pericardial Effusion by Echocardiography. Annals of Surgery 165, 826–829.
Pepi M Muratori M. 2006. Echocardiography in the diagnosis and management of pericardial disease. Journal of Cardiovascular Medicine 7, 533–544.
Pierard LA, Albert A, Henrard L, Lempereur P, Sprynger M, Carlier J. 1986. Incidence and significance of pericardial effusion in acute myocardial infarction as determined by two-dimensional echocardiography. Journal of the American College of Cardiology 8(3), 517–520. http://dx.doi.org/10.1016/S0735-1097(86)80177-2.
Rehman H, Khan SB, Hadi A, Nawaz T, Shah ST, Ullah H. 2010. Frequency of pericardial effusion in patients with first myocardial infarction and its effects on in-hospital morbidity and mortality. Journal of Ayub Medical College Abbottabad 22(2), 184–186.
Riaz A, Kaleem M, Mughal S. 2017. Frequency of Complications of anterior wall myocardial infarction. Pak Heart Journal 50(03), 190–193.
Sagrista-Sauleda J, Merce AS, Soler-Soler J. 2011. Diagnosis and management of pericardial effusion. World Journal of Cardiology 3(5), 135–143.
Saltzman AJ, Paz YE, Rene AG, Green P, Hassanin A, Argenziano MG. 2012. Comparison of surgical pericardial drainage with percutaneous catheter drainage for pericardial effusion. Journal of Invasive Cardiology 24(11), 590–593.
Shah SFA, Hadi A, Faheem M, Ikramullah, Iqbal MA, Gul AM. 2013. Frequency of mechanical complications in patients with acute myocardial infarction. Pak Heart Journal 46(02), 86–90.
Stolz L, Valenzuela J, Situ-LaCasse E, Stolz U, Hawbaker N, Thompson M. 2017. Clinical and historical features of emergency department patients with pericardial effusions. World Journal of Emergency Medicine 8(1), 29–33. http://dx.doi.org/10.5847/wjem.j.1920.
Sugiura T, Iwasaka T, Takayama Y, Matsutani M, Hasegawa T, Takashi N. 1990. Factors Associated With Pericardial Effusion in Acute Q Wave Myocardial Infarction. Circulation 81, 477–481.
Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Alpert JS, White HD. 2012. Third universal definition of myocardial infarction. European Heart Journal 33, 2551–2567. http://dx.doi.org/10.1093/eurheartj/ehs184.
Wunderink RG. 1984. Incidence of Pericardial Effusions in Acute Myocardial Infarctions. Chest 85(4), 494–496. http://dx.doi.org/10.1378/chest.85.4.494