[Pericardial syndrome in the course of pulmonary embolism in personal material].
Dressler-like syndrome has been described in about 3-4% of patients after pulmonary embolism (PE). Out of 207 patients admitted to our hospital in whom the clinical diagnosis of PE was confirmed by scintigraphy, spiral computer tomography and angiography, in 19 patients (9.2%) pericardial fluid was detected and pericardial syndrome (PS) after PE was diagnosed. Other causes of pericarditis were excluded. Mean value of pericardial fluid in echocardiographic examination-behind left ventricular posterior wall was 3.84 mm (range 2-10 mm). No clinical or echocardiographic symptoms of cardiac tamponade were observed. In 6 patients PS complicated clinically massive PE, in 3 patients-non-massive PE, in 10 patients recurrent PE. In 6 patients fibrinolytic and in 13 patients heparin therapy was instituted. In 3 cases corticosteroids were given. No increase of pericardial fluid during fibrinolytic or heparin therapy was observed.


CONCLUSIONS
1. PS after PE is more frequent, than it was estimated previously 2. During therapy of PE the echocardiographic monitoring of the amount of pericardial fluid is mandatory 3. The clinician considering in similar situations the risk-benefit ratio of fibrinolytics and anticoagulants should not abstain from the use of these drugs in the presence of PS after PE, in cases with high probability of cardiac tamponade-pericardial catheter should be used.
Kober
J
J
Kliniki Chorób Wewnetrznych, Instytutu Gruźlicy i Chorób Płuc w Warszawie.
Tomkowski
W
W
Fijałkowska
A
A
Burakowski
J
J
Filipecki
S
S
D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000175:diagnosis / Q000209:etiology*; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis; D012008:Recurrence; D013577:Syndrome