CLINICAL-SIGNIFICANCE OF PERICARDIAL-EFFUSION ASSOCIATED WITH PERICARDITIS IN ACUTE Q-WAVE ANTERIOR MYOCARDIAL-INFARCTION

To elucidate the incidence and clinical factors related to the occurre nce of pericardial effusion in infarction-associated pericarditis, 303 consecutive patients with their first Q-wave anterior myocardial infa rction were examined carefully by means of auscultation, echocardiogra phy, chest radiography, and hemodynamic monitoring. During the first 3 days, a pericardial rub was detected in 65 patients and was absent in 238 patients. Among the 65 patients with pericardial rub, pericardial effusion was present in 27 patients (group 1) and was absent in 38 pa tients (group 2). Although there were no significant differences in ca rdiac output, pulmonary artery wedge pressure and right atrial pressur e between the two groups, patients in group 1 had significantly more l eft ventricular segments with advanced asynergy and higher radiographi c scores (diffuse interstitial infiltrate or alveolar infiltrate) comp ared with those in group 2. Thus, pericardial effusion and increased e xtravascular lung water in infarction-associated pericarditis were not caused by left ventricular failure but by other mechanisms reflecting a larger infarct.