Anticoagulant Treatment in Pericardial Effusion - A Therapeutic Dilemma
Marina Katsman, Elie Shiloah, Micha Rappoport
Dept. of Medicine C, Assaf Harofeh Medical Center, Zerifin
Anticoagulant treatment for acute myocardial infarction (AMI) and pericardial effusion is controversial, since the treatment might cause hemopericardium and tamponade. On the other hand, anticoagulants are strongly indicated in many situations in AMI, including: left ventricular thrombus, unstable angina, severe heart failure, deep vein thrombophlebitis, pulmonary embolism, atrial fibrillation, as part of thrombolytic treatment, and during cardiac catheterization.
We describe a 70-year-old man who presented with both pericardial effusion and a left ventricular thrombus 3 weeks after an extensive, anterior wall AMI. Anticoagulants and corticosteroids were administered simultaneously under hem-odynamic and echocardiographic monitoring, without complications.
It is our impression that anticoagulant treatment is safe in patients with pericardial effusion.