The presence of a subacute or chronic pericarditis with effusion is not a common condition encountered on a surgical service. The surgeon is much more aware of acute pericardial tamponade secondary to penetrating wounds of the heart. Here the condition can easily be suspected by the site and type of injury, as well as the dramatic clinical picture and fairly typical signs.1,2 A small effusion into the pericardial sac may be quickly fatal, since there is little dilatation of the pericardium and shock can occur quickly. Elkin and Campbell3 have reported a case in which 5 cc. of blood in the pericardium has given a 0/0 arterial blood pressure. Subacute or chronic pericarditis, on the other hand, can lead to massive effusion without the striking clinical picture of acute tamponade. Yu et al.8 have reported a case in which pericardial aspiration yielded 1910 cc. of fluid on
MYLES MB, PFEFFER RB, STONE PW. Purulent Pericardial Effusion Treated by Incision and Drainage. AMA Arch Surg. 1957;75(2):287–292. doi:10.1001/archsurg.1957.01280140125023
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