Peri-Myocardial Infarction Pericarditis After Single Stent Early PCI on a STEMI Patient: A Rare Case of Outpatient in Urban Setting

Authors

  • Sidhi Laksono Faculty of medicine, Universitas Muhammadiyah Prof Dr Hamka
  • Axel Jusuf

Keywords:

conservative therapy, percutaneous coronary intervention, pericarditis, peri-myocardial infarction pericarditis, ST elevation myocardial infarction

Abstract

Peri-Myocardial Infarction Pericarditis (PMIP), can occur a few days following a myocardial infarction (MI). PMIP frequently exhibits the auscultatory findings of a pericardial friction rub and pericardial effusion. On the other hand, relatively little is known about the management approach. This study aims to report a patient with PMIP following successful revascularization via Percutaneous Coronary Intervention (PCI) for a recent MI. A 50-year-old male was brought to our Outpatient Clinic with chest pain of two days onset. The patient experienced radiating chest pain, cold sweat, heartburn, and general fatigue. ECG shows extensive anterior ST-elevation myocardial infarction (STEMI), and Troponin T was elevated >2000 ng/L. The patient underwent PCI with single stent deployment. Three days later, the patient experienced dyspnea with Transthoracic Echocardiography (TTE) findings consistent with Early PMIP. The patient was discharged after completing full conservative therapy with good results. The clinical findings of PMIP alone may be subtle and go unnoticed. Clinicians should maintain a high level of suspicion in the era of revascularization and develop a strategic plan for timely diagnosis and management. While anti-inflammatory medical therapy is aimed at reducing inflammation and preventing recurrences and progression of the disease, further research is needed to establish prognostic significance and management strategy since clinically diagnosed PMIP has a benign and self-limiting nature.

References

Michael GS, Bryan VCF, Pragnesh PP, Peter PM, Charles BJ. Peri-Myocardial Infarction Pericarditis: Current Concepts. Clinical Cardiology and Cardiovascular Medicine. Published online June 3, 2019:23-26. doi:10.33805/2639.6807.121

Correale E, Maggioni AP, Romano S, et al. Comparison of frequency, diagnostic and prognostic significance of pericardial involvement in acute myocardial infarction treated with and without thrombolytics. Am J Cardiol. 1993;71(16):1377-1381. doi:10.1016/0002-9149(93)90596-5

LeWinter MM. Pericardial complications of myocardial infarction. UpToDate. Published online 2022. Accessed July 11, 2022. https://www.uptodate.com/contents/pericardial-complications-of-myocardial-infarction

Massalha E, Brodov Y, Oren D, et al. Pericardial Involvement in ST-Segment Elevation Myocardial Infarction as Detected by Cardiac MRI. Front Cardiovasc Med. 2022;9. doi:10.3389/fcvm.2022.752626

Indik JH, Alpert JS. Post-myocardial infarction pericarditis. Curr Treat Options Cardiovasc Med. 2000;2(4):351-355. doi:10.1007/s11936-996-0009-7

Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography Clinical Recommendations for Multimodality Cardiovascular Imaging of Patients with Pericardial Disease. Journal of the American Society of Echocardiography. 2013;26(9):965-1012.e15. doi:10.1016/j.echo.2013.06.023

Verma BR, Montane B, Chetrit M, et al. Pericarditis and Post-cardiac Injury Syndrome as a Sequelae of Acute Myocardial Infarction. Curr Cardiol Rep. 2020;22(10). doi:10.1007/s11886-020-01371-5

Imazio M, Hoit BD. Post-cardiac injury syndromes. An emerging cause of pericardial diseases. Int J Cardiol. 2013;168(2):648-652. doi:10.1016/j.ijcard.2012.09.052

Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015;36(42):2921-2964. doi:10.1093/eurheartj/ehv318

Widimský P, Gregor P. Pericardial Involvement During the Course of Myocardial Infarction. Chest. 1995;108(1):89-93. doi:10.1378/chest.108.1.89

Patel MR, Meine TJ, Lindblad L, et al. Cardiac tamponade in the fibrinolytic era: Analysis of >100000 patients with ST-segment elevation myocardial infarction. Am Heart J. 2006;151(2):316-322. doi:10.1016/j.ahj.2005.04.014

Montrief T, Davis WT, Koyfman A, Long B. Mechanical, inflammatory, and embolic complications of myocardial infarction: An emergency medicine review. American Journal of Emergency Medicine. 2019;37(6):1175-1183. doi:10.1016/j.ajem.2019.04.003

O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary. Circulation. 2013;127(4):529-555. doi:10.1161/CIR.0b013e3182742c84

Imazio M, Adler Y, Charron P. Recurrent Pericarditis: Modern Approach in 2016. Curr Cardiol Rep. 2016;18(6). doi:10.1007/s11886-016-0727-8

Downloads

Published

2024-06-18

How to Cite

Laksono, S., & Jusuf, A. (2024). Peri-Myocardial Infarction Pericarditis After Single Stent Early PCI on a STEMI Patient: A Rare Case of Outpatient in Urban Setting. Ahmad Dahlan Medical Journal, 5(1), 1–8. Retrieved from https://journal2.uad.ac.id/index.php/admj/article/view/9495

Issue

Section

Articles