本間 友基², 溝口 敬一郎², 加来 秀基², 加来 信雄¹, 古賀 義則²

Tomoki HOMMA², Kei-ichiro MIZOGUCHI², Hidiki KAKU², Nobuo KAKU¹, Yoshinori KOGA²

¹久留米大学救命救急センター, ²久留米大学第3内科

¹Critical Care Center, Kurume University School of Medicine, ²Third Department of Internal Medicine, Kurume University School of Medicine

キーワード : Acute myocardial infarction (AMI), Pericardial effusion, Pericarditis, Apical asynergy

We have studied 33 patients within 24 hours of onset of transmural acute myocardial infarction (AMI) to determine the frequency of pericardial effusion (PE) and its clinical manifestations. We performed a study using 2-D and M-mode echocardiography on the 1st, 2nd, 3rd, 4th, 5th, 7th, 10th and 14th days after AMI.
We found 20 cases of PE (61%). Out of 23 patients with anterior AMI, 16 exhibited PE. Out of 10 patients with inferior AMI, 4 exhibited PE. Among the 20 PE cases, 19 (95%) had the effusion in the anterior part of the heart. Fifteen cases showed only small volume of effusion and 5 showed moderate volume. PE usually appeared by the 5th day and continued to the 14th. There was a higher incidence of PE in patients with pericarditis (11/14: 79%) than in those without (9/19: 47%). There was also a higher incidence of PE in patients with apical asynergy (14/16: 88%) than in those without (6/17: 35%, pWe concluded that pericardial effusion most often appears in the anterior portion of the heart and is closely correlated with pericarditis and apical asynergy.