Echocardiography
can be of great assistance in the evaluation of a patient who, either
in the immediate post-infarction period or later during recovery,
develops complications.
 |
| Fig. 55 |
The most common complication is Dressler's syndrome, a pericarditis
typically occurring a few weeks after myocardial infarction. Echocardiography
is valuable for detecting the presence of an effusion and for showing
that any apparent increase in heart size is due to this and not
to the development of a ventricular aneurysm. The appearance of
the effusion is as previously discussed. (Fig. 55) shows a small
pericardial effusion in a patient with new onset of pleuritic-type
chest pain three weeks following myocardial infarction.
With a large effusion and impaired ventricular filling, cardiac
tamponade may develop. The provisional diagnosis is usually made
from the clinical signs, but rapid echocardiographic confirmation
of a large effusion in the presence of tamponade physiology indicates
the need for pericardiocentesis.
2004