Acute idiopathic pericarditis: clinical features, development and complications. Prospective study of 101 cases
Admetlla, M.; Cequier, A.; Amer, R.; Javaloyas, M.; Sabaté, X.; Gausí, C.
Medicina Clinica 85(14): 563-567
1985
ISSN/ISBN: 0025-7753 PMID: 4079531 Document Number: 263126
A prospective follow-up study of 101 patients with the diagnosis of acute idiopathic pericarditis (AIP) was carried out to evaluate the incidence of the presenting clinical features, the response to the treatment with acetyl-salicylic acid (ASA) (4g/day) and the rate of early and late complications. The patients were classified in three groups depending on the number of days from the beginning of symptoms of the moment of admission: Group I, 0-3 days; group II, 4-14 days; and group III, more than 14 days of evolution. 22.7% of patients had had a preceding upper respiratory infection with in the 3 weeks before symptoms of pericarditis. Some of the presenting clinical features ad different prevalences depending on the duration of the disease. When patients of group I were compared to those in group III, it was seen that cardiomegaly, pleural effusion and T-wave flattening were significantly more frequent in the patients with longer illnesses (p < 0.01, p < 0.05 and p < 0.001, respectively). On the contrary, in group I patients a higher prevalence of chest pain and ST elevation (p < 0.001 and p < 0.001) was observed. Eighty-nine (93.6%) out of 95 patients who had received ASA had a favourable response before the 10th day. After a mean follow-up period of 18 .+-. 10 months (mean .+-. standard deviation), 93 patients remained symptom-free and 8 (8%) had had one or more relapses. Of these eight, two had developed constrictive pericarditis and had required pericardiectomy. No significant differences were observed when the complications were related to the initial groups of evolution.