Significance of a pericardial friction rub after streptokinase therapy for acute myocardial infarction

ABSTRACT

To evaluate the clinical incidence and outcome of patients with pericarditis after streptokinase therapy for acute myocardial infarction, 113 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 8% of patients developed a rub during AMI, a low% compared with that in the prethrombolytic era. A pericardial friction rub more often occurred in the setting of an anterior wall AML Patients when compared to those without, a pericardial friction rub had lower ejection fraction [40 vs. 54%, p=0.003]; worse regional left ventricular function; higher in-hospital mortality [22 vs. 10%, p=0.05]; a higher frequency of power failure [100 vs. 54%]; a higher frequency of anterior wall location of the AMI [78% of cases, p=0.003]. Therefore, although the frequency of a pericardial friction rub was low [8%] compared with that in the prethrombolytic era, its occurrence denotes more extensive myocardial damage with a worse clinical outcome. Perhaps with successful reperfusion, 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