• Alp Aydinalp, Alice Wishniak, Lily van den Akker-Berman, Tsafrir Or, and Nathan Roguin.
• Department of Cardiology, Western Galilee Hospital, Nahariya, Israel.
• Isr Med Assoc J. 2002 Mar 1;4(3):181-3.

BackgroundMyocardial infarction-associated pericarditis is a common cause of chest pain following MI, its frequency depending on how it is defined.ObjectivesTo investigate the incidence of acute pericarditis and pericardial effusion in the acute phase of ST-elevation MI treated with thrombolytic therapy.MethodsThe study group comprised 159 consecutive patients fulfilling the criteria for acute MI who were admitted to our department during 18 months. Infarct-associated pericarditis was defined as the finding of a pericardial friction rub, a typical pleuropericardial pain, or both. All patients underwent physical examination of the cardiovascular system four times daily for 7 days, as well as daily electrocardiogram and echo Doppler examinations.ResultsFourteen patients (8.8%) developed a friction rub and 11 patients (6.9%) had a mild pericardial effusion. Six patients (4.0%) had both a friction rub and pericardial effusion. Two patients had a friction rub for more than 7 days. Pleuropericardial chest pain was present in 31 patients (19.5%) but only 7 of them had a friction rub. The in-hospital mortality rate was 1.3% and no mortality was observed in the acute pericarditis group.ConclusionThe incidence of signs associated with acute pericarditis was lower in MI patients treated with thrombolysis, compared with historical controls, when a friction rub and/or pericardial effusion was present. There was no significant reduction in the incidence of pleuropericardial chest pain.

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