Frequency and clinical significance of pericardial friction rubs in the acute phase of myocardial infarction

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Abstract
An early pericardial friction rub was noted in 23.4% of a population of 1264 consecutive patients admitted with acute myocardial infarction. The incidence of the rub did not vary with age, sex or past cardiac history. The pericardial rub, however, was more often a complication of Q- than non-Q-wave infarcts (25.5% vs 10 5%, P > 0.001) and of anterior than inferior infarcts (35.3% vs 20.8%. P > 0.001). In comparing the 297 patients with a pericardial rub to the 967 others, we noted that the former group had a higher CK peak (1706±1110 UII−1 vs 1189±1038 UIl−1, P>0.O01) and a higher incidence of Killip class > 1 (47.5% vs 33.2%, P>0001), a trial flutter or fibrillation (22.2% vs 93%, P>0.001), second or third degree atrio-ventricular blocks (16.8% vs 9.4%, P>0.001) and complete bundle branch block (14.5% vs 7.1%, P > 0001). In spite of this, the development of a pericardial rub did not increase the in-hospital mortality (10.8% in patients with pericardial rub; 11.3% in those without).