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Usefulness of a pericardial friction rub after thrombolytic therapy during acute myocardial-infarction in predicting amount of myocardial damage

Academic Article
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Overview

authors

  • Wall, T. C.
  • Califf, R. M.
  • Harrelson-Woodlief, S. L.
  • Mark, D. B.
  • Honan, M.
  • Abbotsmith, C. W.
  • Candela, R.
  • Berrios, E.
  • Phillips, H. R.
  • Topol, Eric

publication date

  • 1990

journal

  • American Journal of Cardiology  Journal

abstract

  • To evaluate the clinical incidence and outcomes of patients with pericarditis after thrombolytic therapy, 810 patients were prospectively studied during acute myocardial infarction (AMI). Pericarditis was defined as the presence of a pericardial friction rub during the hospital course. Only 5% of patients developed a rub during AMI, a low percent compared with that in the prethrombolytic era. A pericardial friction rub more often occurred in the setting of an anterior wall AMI. Patients with, compared to those without, a pericardial friction rub had lower ejection fractions (45 vs 51%, p = 0.002); worse regional left ventricular function (-3.2 vs 2.7, standard deviation per chord); higher in-hospital mortality (15 vs 6%, p = 0.056); a higher frequency of power failure (83 vs 57%); a higher frequency of anterior wall location of the AMI (53% of cases, p = 0.002); and a higher frequency of 3-vessel disease. Therefore, although the frequency of a pericardial friction rub was low (5%) compared with that in the prethrombolytic era, its occurrence denotes more extensive myocardial damage with a worse clinical outcome. Perhaps with successful reperfusion of the infarct-related vessel, transmural myocardial necrosis is prevented and with it the development of pericarditis. Cardiac tamponade did not occur clinically in any patient who developed a pericardial friction rub.

subject areas

  • Female
  • Heart Auscultation
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction
  • Pericarditis
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator
  • Urokinase-Type Plasminogen Activator
  • Ventricular Function, Left
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Identity

International Standard Serial Number (ISSN)

  • 0002-9149

Digital Object Identifier (DOI)

  • 10.1016/0002-9149(90)90526-7

PubMed ID

  • 2123603
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Additional Document Info

start page

  • 1418

end page

  • 1421

volume

  • 66

issue

  • 20

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