Mehmet ESEN, Nurşah BAŞOL, Serhat KOYUNCU

Miyokard İnfarktüsü Ön Tanısıyla Sevk Edilen Perikardit Olgusu

Perikardit, perikardın enfeksiyöz, üremi, malignite, cerrahi, otoimmün hastalıklar ve travma gibi çesitli patolojik etkenlere karşı verdiği inflamatuar bir yanıttır. Perikardit nedenleri arasında en sık; idiyopatik/virüsler (%78), malignite (%7), tüberküloz (%5), diğer bakteriyel enfeksiyonlar (%4) ve kollajen doku hastalıkları (%3) gösterilmektedir. Miyokardiyal inflamasyon veya epikardiyal hasarlanmanın derecesine bağlı elektrokardiyografi (EKG)’sinde farklı ST ve T dalga değisiklikleri olustuğuna inanılmaktadır. Bu makalede göğüs ağrısı şikayeti ile gelen, yaygın ST elevasyonu nedeni ile miyokard infarktüsü ön tanısıyla sevkedilen akut perikardit vakasını sizlerle paylaşmak istedik.

Anahtar Kelimeler:

Akut perikardit, akut miyokard infarktüsü, EKG

A Pericarditis Case Referred with A Myocardial Infarction Pre-Diagnosis

Acute pericarditis is an inflammatory response to various pathological factors such as pericardial infectious, uremia, malignancy, surgery, autoimmune diseases and trauma. The most common causes of pericarditis are; idiopathic / viruses (78%), malignancy (7%), tuberculosis (5%), other bacterial infections (4%) and collagen tissue diseases (3%). Depending on the degree of myocardial inflammation or epicardial damage, different ST and T wave changes are believed to occur in electrocardiography (ECG). In this article, we wanted to share with you the case of acute pericarditis presented with pre-diagnosis of myocardial infarction with diffuse ST elevation associated with chest pain complaints.

Keywords:

Acute pericarditis, acute myocardial infarction, ECG,

PDF

___

1. Spodick DH. Pericardial disease. In: Braunwald E, Zipes DP, Libby P, eds. Heart Disease. 6th ed. Philadelphia: WB Saunders Company; 2001. p.1823-71.
2. Kabbani SS, LeWinter M. Pericardial disease. In: CrawfordM, DiMarco JP, eds. Cardiology. 1st ed. London: Mosby; 2001. p.15.1-15.14.
3. Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, Brucato A, Gueret P, Klingel K, Lionis C. European Society of Cardiology (ESC). 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921-64.
4. Imazio M. Contemporary management of pericardial diseases. Curr Opin Cardiol. 2012;27(3):308–17.
5. Imazio M, Gaita F. Diagnosis and treatment of pericarditis. Heart. 2015;101(14):1159-68.
6. Khandaker MH, Espinosa RE, Nishimura RA, Sinak LJ, Hayes SN, Melduni RM, Oh JK. Pericardial disease: diagnosis and management. Mayo Clin Proc. 2010;85(6):572-93.
7. Imazio M, Spodick DH, Brucato A, Trinchero R, Adler Y. Controversial issues in the management of pericardial diseases. Circulation. 2010;121(7):916-28.
8. Zayas R, Anguita M, Torres F, et al. Incidence of specific etiology and role of methods for specific etiologic diagnosis of primary acute pericarditis. Am J Cardiol 1995;75:378-82.
9. Kanadaşı M, Çaylı M, Demirtaş M. Pericarditis: Review. Turkiye Klinikleri J Med Sci 2005;25:693-705.
10. Petrofsky M. Management of Malignant Pericardial Effusion. J Adv Pract Oncol. 2014;5(4):281-9.
11. Imazio M, Adler Y. Management of pericardial effusion. Eur Heart J. 2013;34(16):1186-97.
12. Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349(7):684-90.
13. Burazor I, Imazio M, Markel G, Adler Y. Malignant pericardial effusion. Cardiology. 2013;124(4):224-32.
14. Risti AD, Imazio M, Adler Y, Anastasakis A, Badano LP, Brucato A, Caforio AL, Dubourg O, Elliott P, Gimeno J, Helio T. Triage strategy for urgent management of cardiac tamponade: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2014;35(34):2279-84.
15. Levine MJ, Lorell BH, Diver DJ et al. Implications of echocardiographically assisted diagnosis of pericardial tamponade in contem-porary medical patients: detection before hemodynamic embarrassment. J Am Coll Cardiol 1991; 17: 59-65.
16. Chuttani K, Pandian NG, Mohanty PK et al. Left ventricular diastolic collapse: an echocardiographic sign of regional cardiac tamponade. Circulation. 1991;83:1999-2006.
17. Klein AL, Abbara S, Agler DA, Appleton CP, Asher CR, Hoit B, Hung J, Garcia MJ, Kronzon I, Oh JK.American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013;26(9):965-1012.e15.
18. Cosyns B, Plein S, Nihoyanopoulos P, Smiseth O, Achenbach S, Andrade MJ, Pepi M, Ristic A, Imazio M, Paelinck B, Lancellotti P. European Association of Cardiovascular Imaging (EACVI); European Society of Cardiology Working Group (ESC WG) on Myocardial and Pericardial diseases. European Association of Cardiovascular Imaging (EACVI) position paper: multimodality imaging in pericardial disease. Eur Heart J Cardiovasc Imaging. 2015;16(1):12-31.
19. 19.Imazio M, Brucato A, Mayosi BM, Derosa FG, Lestuzzi C, Macor A, Trinchero R, Spodick DH, Adler Y. Medical therapy of pericardial diseases: part II: Noninfectious pericarditis, pericardial effusion and constrictive pericarditis. J Cardiovasc Med (Hagerstown). 2010;11(11):785-94.
20. 20.Imazio M, Bobbio M, Cecchi E, Demarie D, Demichelis B, Pomari F, Moratti M, Gaschino G, Giammaria M, Ghisio A, Belli R, Trinchero R. Colchicine in addition to conventional therapy for acute pericarditis: results of the COlchicine for acute PEricarditis (COPE) trial. Circulation. 2005;112(13):2012-16.
21. Imazio M, Mayosi BM, Brucato A, Markel G, Trinchero R, Spodick DH, Adler Y. Triage and management of pericardial effusion. J Cardiovasc Med (Hagerstown). 2010;11(12):928-35.
22. Christian W. Hamm, Jean-Pierre Bassand, Stefan Agewall, Jeroen Bax, Eric Boersma, Hector Bueno, Pio Caso, Dariusz Dudek, Stephan Gielen. Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the Task Force for the management of acute coronary syndromes in patients presenting without persistent ST-segment melevation of the European Society of Cardiology. Eur Heart J. 2011; 32:2999–3054
23. Thygesen K, Alpert JS, White HD, Jaffe AS, Apple FS, Galvani M, Katus HA. Universal defi- nition of myocardial infarction. Circulation. 2007;116:2634–2653.