Post myocardial infarction pericarditis: Difference between revisions
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==Differentiating Post MI Pericarditis from other Conditions== | ==Differentiating Post MI Pericarditis from other Conditions== | ||
Post myocardial infarction pericarditis occurs between days 2 and 4 after the myocardial infarction. In contrast, [[Dressler's syndrome]] typically occurs 2 to 10 weeks after a myocardial infarction has occurred<ref>{{cite journal | author = Krainin F, Flessas A, Spodick D | title = Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram. | journal = N Engl J Med | volume = 311 | issue = 19 | pages = 1211-4 | year = 1984 | id = PMID 6493274}}</ref>. Post MI pericarditis also needs to be differentiated from [[pulmonary embolism]], another identifiable cause of [[pleuritic]] (and non-pleuritic) [[chest pain]] in people who have been hospitalized and/or undergone surgical procedures within the preceding weeks. | Post myocardial infarction pericarditis occurs between days 2 and 4 after the myocardial infarction. In contrast, [[Dressler's syndrome]] typically occurs 2 to 10 weeks after a myocardial infarction has occurred<ref>{{cite journal | author = Krainin F, Flessas A, Spodick D | title = Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram. | journal = N Engl J Med | volume = 311 | issue = 19 | pages = 1211-4 | year = 1984 | id = PMID 6493274}}</ref>. Post MI pericarditis also needs to be differentiated from [[pulmonary embolism]], another identifiable cause of [[pleuritic]] (and non-pleuritic) [[chest pain]] in people who have been hospitalized and/or undergone surgical procedures within the preceding weeks. | ||
==Treatment== | |||
Post MI pericarditis is typically treated with high dose (up to 650 mg PO q 4 to 6 hours) enteric-coated [[aspirin]]. [[Acetominophen]] can be added for pain management as this does not affect the coagulation system. Anticoagulants should be discontinued if the patient develops a [[pericardial effusion]]. | |||
[[Non-steroidal_anti-inflammatory_drug|NSAIDs]] such as [[ibuprofen]] should be avoided in the peri-infarct period as they: | |||
#Increase the risk of [[reinfarction]] | |||
#Adversely impact left ventricular remodeling | |||
#Block the effectiveness of [[aspirin]] | |||
==References== | ==References== | ||
Revision as of 16:18, 8 May 2014
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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]
Overview
Post MI pericarditis occurs in 17% to 25% of patients 2 to 4 days following an MI.
Epidemiology and Demographics
Post MI pericarditis occurs in 17 to 25% of cases of acute myocardial infarction.
Differentiating Post MI Pericarditis from other Conditions
Post myocardial infarction pericarditis occurs between days 2 and 4 after the myocardial infarction. In contrast, Dressler's syndrome typically occurs 2 to 10 weeks after a myocardial infarction has occurred[1]. Post MI pericarditis also needs to be differentiated from pulmonary embolism, another identifiable cause of pleuritic (and non-pleuritic) chest pain in people who have been hospitalized and/or undergone surgical procedures within the preceding weeks.
Treatment
Post MI pericarditis is typically treated with high dose (up to 650 mg PO q 4 to 6 hours) enteric-coated aspirin. Acetominophen can be added for pain management as this does not affect the coagulation system. Anticoagulants should be discontinued if the patient develops a pericardial effusion.
NSAIDs such as ibuprofen should be avoided in the peri-infarct period as they:
- Increase the risk of reinfarction
- Adversely impact left ventricular remodeling
- Block the effectiveness of aspirin
References
- ↑ Krainin F, Flessas A, Spodick D (1984). "Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram". N Engl J Med. 311 (19): 1211–4. PMID 6493274.