CLINICAL-SIGNIFICANCE OF PERICARDIAL-EFFUSION IN Q-WAVE INFERIOR WALLACUTE MYOCARDIAL-INFARCTION

To assess the clinical significance of pericardial effusion in Q-wave inferior wall acute myocardial infarction, 185 consecutive patients we re examined by means of electrocardiogram, echocardiogram and hemodyna mic monitoring. A pericardial effusion was present In 44 patients and was absent in 141 patients. Electrocardiographic right ventricular inf arction (greater than or equal to 1 mm of ST-segment elevation and Q w ave in V(4)R) was detected in 54 patients, with 20 patients having per icardial effusion. Patients with pericardial effusion had significantl y more left ventricular segments with advanced asynergy, lower cardiac output, higher pulmonary artery wedge pressure and higher in incidenc e of right ventricular infarction than those without pericardial effus ion. There were 17 in-hospital deaths. Although there was no significa nt difference in the mortality rate between patients with and without right ventricular infarction, a significantly higher hospital mortalit y rate was observed in patients with pericardial effusion compared to those without it (23 vs 5%). Pericardial effusion was selected with ag e and pulmonary artery wedge pressure as important variables associate d with hospital mortality by the discriminant analysis. Patients who d eveloped pericardial effusion, regardless of right ventricular infarct ion, had more extensive myocardial damage, and hence, pericardial effu sion was one of the predictors of increased hospital mortality.