Skip to main content
Clinical Cardiology logoLink to Clinical Cardiology
. 2009 Mar 19;32(3):115–120. doi: 10.1002/clc.20444

Regional Pericarditis: A Review of the Pericardial Manifestations of Acute Myocardial Infarction

Todd A Dorfman 1, Raed Aqel 2,
PMCID: PMC6653587  PMID: 19301285

Abstract

Regional pericarditis has been described in several settings, but occurs most frequently after transmural myocardial infarction. While the diagnosis remains elusive, it must be considered in all patients with recurrent chest pain following acute myocardial infarction (AMI). Pericarditis classically presents with positional chest pain, a pericardial friction rub, diffuse ST‐segment elevation, and PR depression, but regional ECG changes associated with infarction‐associated pericarditis sometimes exist. Given the magnitude and frequency of AMI, it is imperative to be aware of the myriad of pericardial manifestations of myocardial injury. An illustrative case and a comprehensive review of the literature will be provided. Copyright © 2009 Wiley Periodicals, Inc.

Keywords: regional pericarditis, infarction‐associated pericarditis, pericardial effusion

Full Text

The Full Text of this article is available as a PDF (1.5 MB).

References

  • 1. Aydinalp A, Wishniak A, van den Akker‐Berman L, Or T, Roguin N: Pericarditis and pericardial effusion in acute ST‐elevation myocardial infarction in the thrombolytic era. Isr Med Assoc J 2002; 3: 181–183. [PubMed] [Google Scholar]
  • 2. Widimsky P, Gregor P: Pericardial involvement during the course of myocardial infarction. A long‐term clinical and echocardiographic study. Chest 1995; 108(1): 89–93. [DOI] [PubMed] [Google Scholar]
  • 3. Krainin FM, Flessas AP, Spodick DH: Infarction‐associated pericarditis. Rarity of diagnostic electrocardiogram. N Engl J Med 1984; 311(9): 1211–1214. [DOI] [PubMed] [Google Scholar]
  • 4. Wall TC, Califf RM, Harrelson‐Woodlief L, Mark DB, Honan M, et al.: Usefulness of a pericardial friction rub after thrombolytic therapy during acute myocardial infarction in predicting amount of myocardial damage. The TAMI Study Group. Am J Cardiol 1990; 66(20): 1418–1421. [DOI] [PubMed] [Google Scholar]
  • 5. Sugiura T, Iwasaka T, Takayama Y, Matsutani M, Hasegawa T, et al.: Factors associated with pericardial effusion in acute Q wave myocardial infarction. Circulation 1990; 81(12): 477–481. [DOI] [PubMed] [Google Scholar]
  • 6. Oliva PB, Hammill SC, Edwards WD: Electrocardiographic diagnosis of postinfarction regional pericarditis. Ancillary observations regarding the effect of reperfusion on the rapidity and amplitude of T wave inversion after acute myocardial infarction. Circulation 1993; 88(3): 896–904. [DOI] [PubMed] [Google Scholar]
  • 7. Sugiura T, Iwasaka T, Takehana K, Nagahama Y, Taniguchi H, Inada M. Clinical significance of pericardial effusion associated with pericarditis in acute Q‐wave anterior myocardial infarction. Chest 1993; 104(2): 415–418. [DOI] [PubMed] [Google Scholar]
  • 8. Galve E, Garcia‐Del‐Castillo H, Evangelista A, Batlle J, Permanyer‐Miralda G, et al.: Pericardial effusion in the course of myocardial infarction: incidence, natural history, and clinical relevance. Circulation 1986; 73(2): 294–299. [DOI] [PubMed] [Google Scholar]
  • 9. Correale E, Maggioni AP, Romano S, Riccardiello V, Battista R, et al.: Comparison of frequency, diagnostic and prognostic significance of pericardial involvement in acute myocardial infarction treated with and without thrombolytics. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI). Am J Cardiol 1993; 71(16): 1377–1381. [DOI] [PubMed] [Google Scholar]
  • 10. Correale E, Maggioni AP, Romano S, Ricciardiello V, Battista R, et al.: Pericardial involvement in acute myocardial infarction in the post‐thrombolytic era: Clinical meaning and value. Clin Cardiol 1997; 20(4): 327–331. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11. Oliva PB, Hammill SC, Edwards WD: The electrocardiographic diagnosis of regional pericarditis in acute inferior myocardial infarction. Eur Heart J 1993; 14(12): 1683–1691. [DOI] [PubMed] [Google Scholar]
  • 12. Oliva PB, Hammill SC, Edwards WD: Cardiac rupture, a clinically predictable complication of acute myocardial infarction: Report of 70 cases with clinicopathologic correlations. J Am Coll Cardiol 1993; 22(3): 720–726. [DOI] [PubMed] [Google Scholar]
  • 13. Buchell H, Barnes A, Mann F: The electrocardiographic picture of experimental localized pericarditis. Am Heart J 1939; 18: 133–144. [Google Scholar]
  • 14. Youssef G, Khouzam S, Sprung J, Bourke DL: Regional pericarditis mimicking myocardial infarction. Anesthesiology 2001; 95(1): 261–264. [DOI] [PubMed] [Google Scholar]
  • 15. Jain A: “Tombstone” anterior ST‐segment elevations secondary to acute pericarditis: The role of two‐dimensional echocardiogram. Clin Cardiol 1997; 20(4): 404–406. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Clinical Cardiology are provided here courtesy of Wiley

RESOURCES