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.