INTRODUCTION
When sudden cardiac tamponade occurs after acute myocardial infarction,
bleeding complications such as post-acute myocardial rupture, coronary
artery hemorrhage, and acute aortic dissection are possible. Our report
describes a case of purulent pericarditis complicated by acute
myocardial infarction. The reported routes of infection in purulent
pericarditis include contamination from open wounds (chest stab wounds
or the surgical field), infective endocarditis, pneumonia, the
subdiaphragmatic spread of infection, and hematogenous spread of a
remote infection.
Although hypotension due to pericardial tamponade may occur in purulent
pericarditis, it may also arise from septic shock, and appropriate
treatment such as drainage and antibiotics should be promptly
administered. When cardiac tamponade complicating acute myocardial
infarction is encountered, hemorrhagic complications are the primary
concern; however, purulent pericarditis also remains a possibility.
Purulent pericarditis associated with acute myocardial infarction is
rare but may rapidly worsen; thus, it requires prompt diagnosis. To make
a prompt and accurate diagnosis, it is necessary to remember that
purulent pericarditis is a possible cause of cardiac tamponade after
myocardial infarction. The incidence of pericarditis after acute
myocardial infarction has decreased with early reperfusion and is
reported to range from 4 to 7%. To the best of our knowledge, findings
similar to ours have not been reported previously, and we believe that
this case report is important to improve patient outcomes in this
critical situation.