There can scarcely be any better comment on the difficulty in diagnosticating pericarditis with effusion than can be read out of statistics from the postmortem room. Even in institutions where the diagnostic work is admittedly of a high order, the postmortem findings of pericardial exudates entirely unsuspected during life is of not infrequent occurrence. Any one who has been especially interested in the subject must have been struck with the difficulties which are at times encountered in making the diagnosis of such an effusion. Of course, when a well defined friction rub develops in the course of rheumatism, and is followed by a gradual increase in the cardiac silhouette, there can be little difficulty in the diagnosis. On the other hand, in the absence of a pericardial rub, the differentiation between a dilated heart and an effusion may really be very difficult. A considerable number of cases have been reported
WILLIAMSON CS. PERICARDITIS WITH EFFUSION. AN EXPERIMENTAL STUDY. Arch Intern Med (Chic). 1920;25(2):206–228. doi:10.1001/archinte.1920.00090310089004
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