Myocardial infarction: pericardial effusions were common.

Clinical bottom line (level 4)

  1. A quarter of patients with a myocardial infarction had a pericardial effusion after 3 days.
  2. Absence of a pericardial rub could not exclude an effusion.
Sugiura et al: Circulation 1990; 81 (2): 477-481
Expires March 2003

The study

Setting: coronary care unit, university hospital, Japan

330 patients (aged mean 62 years, 72% male) with a myocardial infarction who survived at least 3 days

Excluded if
  • unsatisfactory ECG



    • Independent unblinded reference standard, applied in all patients from a consecutive appropriate spectrum.
    Reference standard:
    • echocardiography
    Diagnostic test: pericardial rub, considered as a to-and-fro scratchy or grating noise heard in systole, mid-diastole, and presystole or in only one of these phases. Diagnosis of pericardial effusion was made after confirmation by at least to cardiologists

    The evidence

    pre-test probability of pericardial effusion: 25%, (95% CI: 21% to 30%)
    • sensitivity of pericardial rub: 46% (95% CI: 35% to 57%)

    Comments

    1. No information was given on the number of patients who had a pericardial rub and no effusion.

    Citation

    1. Sugiura T, Iwasaka T, Takayama Y, et al: Factors associated with pericardial effusion in acute Q wave myocardial infarction. Circulation 1990; 81 (2): 477-481
    Contributor: Chris Ball and Clare Wotton, February 2000
    Reviewer:

    Clinical Question.
    Patient myocardial infarction
    Intervention or Exposure pericardial rub
    Outcome pericardial effusion