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Article
April 1924

CONDUCTION CHANGES ACCOMPANYING PERICARDIAL EFFUSION: WITH A CONSIDERATION OF A LOCAL CIRCULATORY FACTOR IN HEART BLOCK

Author Affiliations

NEW YORK

From the Cardiac Clinic of the New York Hospital.

Arch Intern Med (Chic). 1924;33(4):449-458. doi:10.1001/archinte.1924.00110280047005
Abstract

To the effect of pericardial effusion on heart function scant attention has been paid by pathologic physiologists; while clinical emphasis has been directed toward those external manifestations—chiefly the manner and degree of the extension of the limits of cardiac dulness— which provide essential means for the diagnosis of accumulation of liquid in the pericardial cavity. Moreover, the picture is so frequently complicated by a concomitant infection and by inflammatory lesions in the heart muscle or valves that the intrinsic effect of the effusion is obscured. Thus MacKenzie1 dismisses the subject by stating that he has "never found any very serious embarrassment of the heart from extensive pericardial effusion, the reason being probably that while the normal pericardium is a more or less inelastic bag, with the inflammatory invasion it becomes distensible, and therefore able to accommodate an enormous amount of fluid with little embarrassment to the heart."

On the other

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