Peri-Infarction Pericarditis, Rare Complication of Myocardial Infarction

Author : S.A. Hutomo, Andrianto
Upload Date : 19-04-2018

Background: Myocardial infarction could lead to various complications, including pericardial complications. Acute pericarditis is one of pericardial complication which are rare in reperfusion era. Nevertheless, the pericardial complication could alter the management of patient with myocardial infarction

Case: A male, 58 y.o, came to ER with acute typical chest pain, since 3 days ago, worsening in last 3 hours. The risk factors was heavy smoker and diabetes. Physical examination reflects circulatory shock (hypotension, tachycardia, low urine production). No ronchi. ECG shows sinus tachycardia rhythm 140 bpm, with pathologic Q waves and ST elevation at V2-V5, I-aVL leads. Troponin was high (13.1) indicating a recent infarction. The patient was not going to PCI because of financial issue. And then echocardiography was performed. Echocardiography shows hypokinetic in anterior, antero-septal and anterolateral segments. EF was 45% (biplane) It also shows pericarditis sign, moderate pericardial effusion at basal, inferior causing right atrial collapse. The acute treatment was oxygenation, administration of intravenous fluid bolus (1000 ml NaCl 0.9%) with close monitoring, dobutamine injection, aspirin 750 mg q8h. The patient was stabilized in first 24 hours.

Discussion: Pericarditis could happen in myocardial infarction setting. MI lead the inflammatory reaction that trigger the fluid production in pericardium. The clinical diagnosis of pericarditis in MI setting could be difficult, since the symptoms and ECG were similar. Echocardiography was the key of diagnosis, since it can detect the pericardial effusion, LV function, and hemodynamic status. Acute pericardial effusion may increase intrapericardial pressure rapidly that leads reduction of cardiac filling. It could aggravate hemodynamic status, which already compromised caused by extensive anterior infarct. Thus, the resuscitation strategy must be individually tailored with hemodynamic status of the patient.

Conclusion: We reported patient with acute pericarditis due to myocardial infarction, complicating a pericardial effusion leads to circulatory shock. Echocardiography is a key diagnostic tool to guide the diagnosis and emergency management of patient

KEYWORDS : acute pericarditis, myocardial infarction, shock

Save Item
Similar Articles

The Predictors of No Reflow Phenomenon after Percutaneous Coronary Intervention in Patients with ST Elevation Myocardial Infarction: A Meta-Analysis(Mohammad Saifur Rohman)

Hypoxic Preconditioning Effects on the Expression of Intracellular Heat Shock Protein (HSP) 27, HSP 70 and HSP 90 in Cultured Adipocyte-Derived Mesenchymal Stem Cell (AMSCs) (A. F. Ghaznawie, I.G. Rurus Suryawan, Andrianto)

Q/R duration as a Predictor of No-Reflow in Patients with Acute Anterior Myocardial Infarction Who Underwent Primary Percutaneous Intervention(P. Meidianaser, Andri, F. Harben, S. Masrul)

Clinical Picture and Risk Prediction of Short-Term Mortality of Mechanically Ventilated Patients Presented with Cardiogenic Shock in Intensive Cardiovascular Care Unit of Saiful Anwar General Hospital(H. A. Liemena*, F. W. Nugroho, D. H. Karimullah, Setyasih Anjarwani)

Association between Left Ventricular Global Longitudinal Strain and Functional Capacity Measured with 6 MWT in Patients after Acute Myocardial Infarction(P. Wulandari, T. Wasyanto, N. Purwaningtyas)

Comparison of Interleukin-6 Post Percutaneous Coronary Intervention between Patients with Acute Myocardial Infarction that Underwent Complete and Incomplete Revascularization(P. K. Dewi, S. Rifqi, N. Anggriyani, N. Wijayahadi)

Association between Neutrophil to Lymphocyte Ratio and Left Ventricle Global Longitudinal Strain in Acute Myocardial Infarctions Patients(A. A. Nursidiq, N. Purwaningtyas, T. Wasyanto)

Correlation of Left Ventricular Function and CardShock Risk Score with Altered Mental State in Cardiogenic Shock Patient Treated with Mechanical Ventilation(D.H. Karimullah, L.H. Adrian, F.W. Nugroho, S. Anjarwani)

Precordial ST Segment Depression on Admission Electrocardiogram as a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity in Patients with Inferior Myocardial Infarction(J. Suganti, A. C. Lubis, A. A. Siregar, A. Sitepu, C. A. Andra, A. N. Nasution, H. Hasan)

Assessment of Coronary No-reflow in Patients with Acute Anterior STEMI Underwent Primary Percutaneous Coronary Intervention Using P Wave Peak Time Parameter(P. Andri, M. Meidianaser, Syaoqi, S. Masrul)

Cardiac Power Output Predicts In-Hospital Major Adverse Cardiac Events in Patients with Acute Myocardial Infarction(Y. F. Siregar, K. K. Ilyas, A. A. Siregar, H. Hasan)

The Efficacy of Levosimendan Infusion on Hemodynamic Improvement in Patient Cardiogenic Shock (CS) after Percutaneous Coronary Intervention (PCI) or Intraaortic Balloon Pump (IABP) : a Mini Systematic Review(M. D. Jalma, W. Rahmadhani, J. M. Siahaan)

Selvester Score in Myocardial Infarction, Could It Predict Degree of Severity in Coronary Lesion?(H. Pribadi, J. A. Pangemanan, S. H. Rampengan, A. L. Panda, I. Adriana, Ronaldi, V. F. K. Candra, N)

Estimated Glomerular Filtration Rate And Length of Stay in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention(H. Haryadi, A. A. Asrial, L. Raharjoyo, N. Virginia, K. Rizky ,Y. Herry)

Reduced Left Ventricular Ejection Fraction as A Predictor In-Hospital Major Cardiovascular Event in Patients Admitted with Acute Myocardial Infarction at Sanglah General Hospital Bali(I. D. G. D. Sumajaya, L. O. S. Suastika, A. A. A. D. A. Yasmin, I. G. N. P. Gunadhi)

Electrocardiographic Change Mimicking ST Elevation Myocardial infarction in Subdural Hemorrhage: Diagnostic Dilemma(P.I.N. Sigit, Y. Ahmad)

Isolated Posterior Myocardial Infarct: The Deadly Nightshade of the Electrocardiography(B.D.Guntoro, D.Ilmasari, M.G.Soewandi)

Localized ST Elevation in ECG: Acute Myopericarditis Mimicking ST Elevation Myocardial Infarction(T. N. P. Adityaputra, L. O. S. Suastika)

Recurrent Acute Myocardial Infarction in A-63 years old Man with Hypersensitivity to Aspirin Therapy: How to Deal with it?(M. Sanjiwani, N. Wiryawan)

Double Culprit Coronary Arteries in ST Elevation Myocardial Infarction Treated with Primary Percutaneous Intervention: A Case Report(H.H. Satoto, R. Puspitoadhi, R.A. Raharjo, S. Sungkar, I. Uddin)

Aortic Dissection Presenting With Septic Shock(A. Satria, S. Widito)

Non-ST Elevation Myocardial Infarction Induced by Sildenafil Consumption in a Patient with No Coronary Artery Disease History: A Case Report(I.M.E.A. Wardhana, P.G. Budiana*)

New ST-Segment Elevation After Coronary Artery Bypass: A Case Report(N. O. H. Rantung, L. A. Natalino, V. Sariowan, A. E. Haurissa, A. Tangkilisan, H. Abraham, J.A. Pang)

Extensive Anterior ST elevation Myocardial Infarction in Reproductive Woman Using Oral Contraceptive Pills (D.Ilmasari, A.F.Khalid, M.G.Soewandi)

Converting Persistent Non-Valvular Atrial Fibrillation to Sinus Rhythm in Critical Stenosis of Left Circumflex (LCX) Artery: Is it Ischaemic-related?: A Case Report(F. Ratih, M.F. Rizky, K. Agoes)

Post infarction ventricle septal rupture: it is not always a lethal condition.(N.E. Damaiati, R. A. Sukaton, H. Isnanijah)

Subacute Coronary Stent Thrombosis in Patient after Elective Percutaneous Coronary Intervention : Causes, Risk Factors and Management(A. Chairunnisa, A. Wardhani, Y. Herry, I. Uddin, Safir)

Acute Pericarditis : A case report(I.R. Hidayat, A. P. Ayu, T. T. Dewi, I. Rakhmawati, D. Y. Pertiwi, D. Rostiati)

Acute Pulmonary Embolism Mimicking an Acute Myocardial Infarction : A Case Report(O. M. Siregar, Y. Sarastri, Z. Safri, H. Hasan, )

How To Manage Total Atrioventricular Block In Inferior-Posterior AMI; Is PCI More Superior Than Permanent Pacemaker?(N.D Nuarisa, Y.H Oktaviono)

Copyrights 2018 ASMIHA | Managed by Indonesia Medical Event (IME)