Following a myocardial infarction (MI), patients are at risk for a variety of cardiac complications. Many complications are mechanical (eg, papillary muscle rupture, left ventricular wall rupture, or ventricular septal rupture) and are related to the extent of myocardial injury, while other post-MI complications are immunologic, inflammatory, or iatrogenic.
Three major types of pericardial complications can occur in patients following a myocardial infarction:
- Early infarct-associated pericarditis (often termed peri-infarction pericarditis)
- Pericardial effusion (with or without tamponade)
- Postcardiac injury (Dressler's) syndrome
Each of these complications is related to infarct-size and, as will be described below, has declined in incidence in the revascularization era [1-3]. Details of the nonpericardial complications of MI are discussed separately. (See "Mechanical complications of acute myocardial infarction" and "Prognosis and treatment of cardiogenic shock complicating acute myocardial infarction" and "Left ventricular aneurysm and pseudoaneurysm following acute myocardial infarction".)
Acute pericarditis, generally detected by the presence of a pericardial friction rub with or without chest discomfort, may complicate the course of an acute myocardial infarction (MI) . Peri-infarction pericarditis (PIP) usually occurs soon after the MI and is transient. One study of MI without reperfusion found that 68 percent of audible pericardial rubs were heard on day 1 or 2, 85 percent were audible for less than three days, and persistence of the rub was rare .