Lesions of the pericardium are generally difficult problems in diagnosis. Auenbrugger, Corvisart and Laënnec early recognized these difficulties. Osler not infrequently lamented his failure to recognize a lesion of the pericardium and it would seem that these problems in diagnosis still exist. The chief reason for failure in the diagnosis of pericardial lesions is the fact that the physiologic concept of acute and chronic compression of the heart has not found the place in applied medicine that it deserves. Clinically, almost all of the intrapericardial lesions express themselves, if they express themselves at all, by producing either acute or chronic compression of the heart. Some lesions of the pericardium are entirely silent; they produce no clinical signs whatever and clinical recognition of these silent lesions is not to be expected.1 However, the important group of lesions—important because treatment is effective—produces either acute or chronic compression of the heart. In
BECK CS. TWO CARDIAC COMPRESSION TRIADS. JAMA. 1935;104(9):714–716. doi:10.1001/jama.1935.02760090018005
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