Post myocardial infarction pericarditis: Difference between revisions
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===History and Symptoms=== | ===History and Symptoms=== | ||
The major clinical manifestations of PIP include: | The major clinical manifestations of PIP include: | ||
* Chest pain; typically is centrally-located, sharp, and pleuritic | * Chest pain; typically is centrally-located, sharp, and pleuritic. Pleuritic chest pain is defined as the pain that is worst during deep inspiration and improves by sitting up and leaning forward. | ||
Pleuritic chest pain is defined as the pain that is worst during deep inspiration and improves by sitting up and leaning forward. | * Pericardial friction rub; although diagnostic for PIP, it may not be heard in all patients. A pericardial friction rub is usually described as a superficial scratchy or squeaking sound which is best heard with the diaphragm of the stethoscope over the left sternal border | ||
* Pericardial friction rub; although diagnostic for PIP, it may not be heard in all patients. | * Pericardial effusion. | ||
A pericardial friction rub is usually described as a superficial scratchy or squeaking sound which is best heard with the diaphragm of the stethoscope over the left sternal border | |||
* Pericardial effusion | |||
However, some patients may be asymptomatic and incidental hearing of friction rub may be the only finding in these patients. | However, some patients may be asymptomatic and incidental hearing of friction rub may be the only finding in these patients. | ||
Revision as of 15:11, 27 February 2020
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Pericarditis Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Post myocardial infarction pericarditis On the Web |
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American Roentgen Ray Society Images of Post myocardial infarction pericarditis |
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Risk calculators and risk factors for Post myocardial infarction pericarditis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Synonyms and keywords: post MI pericarditis
Overview
Post-Myocardial Infarction Pericarditis, also named peri-infarction pericarditis, is defined as acute pericarditis occurring within 7 days following an acute myocardial infarction.
Historical Perspective
Classification
Pathophysiology
Extension of myocardial infarction to the epicardial surface, which occurs in transmural MI, causes local pericardial inflammation adjacent to the infarction zone with resultant acute fibrinous pericarditis.
Causes
Acute fibrinous pericarditis occurs following transmural myocardial infarction.
Differentiating peri-infarction pericarditis from other Diseases
The chest pain of pericarditis must be differentiated from post-infarction angina and recurrent infarction. Pleuritic nature of pain and/or radiation of pain to either trapezius ridge may help in differentiating PIP from other causes of chest pain following MI.
Epidemiology and Demographics
The incidence of PIP has decreased in recent years due to following the widespread use of fibrinolytic or mechanical reperfusion therapy. Recent studies estimated an incidence of less than 2% among patients with ST-elevation MI.[1]
Risk Factors
Screening
Natural History, Complications, and Prognosis
PIP is usually self-limited in most patients.
Diagnosis
Diagnostic Study of Choice
- Historically, auscultation of pericardial friction rub has been considered as a diagnostic sign of PIP.
- The diagnosis of PIP is also made with the presence of pleuritic chest pain, particularly pain in one or both trapezius ridges.
History and Symptoms
The major clinical manifestations of PIP include:
- Chest pain; typically is centrally-located, sharp, and pleuritic. Pleuritic chest pain is defined as the pain that is worst during deep inspiration and improves by sitting up and leaning forward.
- Pericardial friction rub; although diagnostic for PIP, it may not be heard in all patients. A pericardial friction rub is usually described as a superficial scratchy or squeaking sound which is best heard with the diaphragm of the stethoscope over the left sternal border
- Pericardial effusion.
However, some patients may be asymptomatic and incidental hearing of friction rub may be the only finding in these patients.
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
There are no x-ray findings associated with post-MI pericarditis.
Echocardiography or Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
There are no other diagnostic studies associated with [disease name].
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
References
- ↑ Lador A, Hasdai D, Mager A, Porter A, Goldenberg I, Shlomo N; et al. (2018). "Incidence and Prognosis of Pericarditis After ST-Elevation Myocardial Infarction (from the Acute Coronary Syndrome Israeli Survey 2000 to 2013 Registry Database)". Am J Cardiol. 121 (6): 690–694. doi:10.1016/j.amjcard.2017.12.006. PMID 29370922.