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Pericardial effusion: A clinical study
568
TllC
AhlERIi’.\S
IIEART
JOT-RN:\1
the method of choice in treating cases of auricular fibrillation, because a perfectly good result can be obtained with certainty in six to eight hours, In cases of vomiting from congestive failure an equally good result may be obtainetl by giving a similar nlassi\-c I~I),V per rectum. calculatctl at the rate of 0.1 C.C. per lb. of body weight. In very urgent cases. where a still mor(’ rapid action is required, a similar result may bc obtained within thirty minutes hp the atlministration of a single intravenous The ?;ite of action in all thret, routes is similar, dose of l/X gr. of strcophanthin. i. e., that they all act I-ia the vagus. as shown by ” vagal release” with atropin. Cases of auricular fibrillation shoulll be given the advantage of being treated by one or other of the methods described. in order that their cliscomfort may be relieved in a day, instead of having it l~rolongcd to a week by the use of older methods. Hansen, Am.
Olga S., Rcr. Tuber.
and Maly, 27:
Henry 200: 19Xl.
W.:
The Effects of Thoracoplasty
on the Heart.
In an attempt to tletcrmine the effects of thoracoplasty on the heart as evidenced by the electrocardiogram, 57 cases have been studied by means of electrocardiograms and x-ray films, before and after the collapse. Thirty casts of uncomplicatecl pulmonary tuberculosis have been taken for controls. It has been shown that the intrathoraeic pathological involvement incident to thoracoplasty almost invariably displaces the heart more or less to une title or the other but most frequently toward the unaffected side. The elcctrocardiogramx also show a high incidence of postoperative change, but these changes arc neither consistent nor predictable, being in agreement It would scem impossible to prewith the x-ray findings in only a third of the eases. dict the probable electrocardiographic change from a study of the x-ray pictures or, conversely, to guess the type of x-ray findings from looking at the elcctrocardiograms. It is probable that the electrical axis may bc influenced by rotation of the heart on its longitudinal axis by fibrotic tissue affecting at t.imes the base, and at times the apex anteriorly or posteriorly. It is probable that other factors such as bed rest, toxemia and weight changes may affect the form of the clcc+ocartliogram, since the control patients who had no gross mechanical changes were also variable in their complexes. There has been no evidence of disturbance in conduction or of myoeardial damage in the electrocardiograms. Autopsy has shown no abnormality in heart weight nor more evidence of myocardial degeneration than is found in other patients dying of tuberculosis. Some of the changes in QRS amplitude probably represent changes in muscle tone associated with reduction of toxemia and inereasc in exercise and would appear regardless of the mechanics of collapse. The changes found in the electrocardiogram are probably due to extrinsic factors and bcnr no relationship to the condition of the heart muscle. Camp,
Paul
D., and White, Paul D.: Pericardial
J. M. SC. 184:
752,
Effusion:
A Clinical
Study.
Am.
1032.
The authors have studied the clinical and pathologic.al data on 126 cases eontaining over 100 C.C. of pcricardial fluid found at postmortem examination over a period of ten years occurring among 95,542 cases admitted to the hospital and among 1,720 necropsies. They conc.lude that without the presence of an acute fibrous pericarditis, the diagnosis of prricardial fluid is likely to be missed unless the effusion amounts to over 500 C.C. Of the 126 cases, a correct clinical diagnosis of pericardial effusion was made only 6 times. To establish a clinical diagnosis of pericardial effusion, all signs and symptoms must be carefully looked for and analyzed and roentgen ray studies employed in all cases except a very few, where the effusion is so large and rapid in its development that the clinical diagnosis is easily made at once.
TllC
AhlERIi’.\S
IIEART
JOT-RN:\1
the method of choice in treating cases of auricular fibrillation, because a perfectly good result can be obtained with certainty in six to eight hours, In cases of vomiting from congestive failure an equally good result may be obtainetl by giving a similar nlassi\-c I~I),V per rectum. calculatctl at the rate of 0.1 C.C. per lb. of body weight. In very urgent cases. where a still mor(’ rapid action is required, a similar result may bc obtained within thirty minutes hp the atlministration of a single intravenous The ?;ite of action in all thret, routes is similar, dose of l/X gr. of strcophanthin. i. e., that they all act I-ia the vagus. as shown by ” vagal release” with atropin. Cases of auricular fibrillation shoulll be given the advantage of being treated by one or other of the methods described. in order that their cliscomfort may be relieved in a day, instead of having it l~rolongcd to a week by the use of older methods. Hansen, Am.
Olga S., Rcr. Tuber.
and Maly, 27:
Henry 200: 19Xl.
W.:
The Effects of Thoracoplasty
on the Heart.
In an attempt to tletcrmine the effects of thoracoplasty on the heart as evidenced by the electrocardiogram, 57 cases have been studied by means of electrocardiograms and x-ray films, before and after the collapse. Thirty casts of uncomplicatecl pulmonary tuberculosis have been taken for controls. It has been shown that the intrathoraeic pathological involvement incident to thoracoplasty almost invariably displaces the heart more or less to une title or the other but most frequently toward the unaffected side. The elcctrocardiogramx also show a high incidence of postoperative change, but these changes arc neither consistent nor predictable, being in agreement It would scem impossible to prewith the x-ray findings in only a third of the eases. dict the probable electrocardiographic change from a study of the x-ray pictures or, conversely, to guess the type of x-ray findings from looking at the elcctrocardiograms. It is probable that the electrical axis may bc influenced by rotation of the heart on its longitudinal axis by fibrotic tissue affecting at t.imes the base, and at times the apex anteriorly or posteriorly. It is probable that other factors such as bed rest, toxemia and weight changes may affect the form of the clcc+ocartliogram, since the control patients who had no gross mechanical changes were also variable in their complexes. There has been no evidence of disturbance in conduction or of myoeardial damage in the electrocardiograms. Autopsy has shown no abnormality in heart weight nor more evidence of myocardial degeneration than is found in other patients dying of tuberculosis. Some of the changes in QRS amplitude probably represent changes in muscle tone associated with reduction of toxemia and inereasc in exercise and would appear regardless of the mechanics of collapse. The changes found in the electrocardiogram are probably due to extrinsic factors and bcnr no relationship to the condition of the heart muscle. Camp,
Paul
D., and White, Paul D.: Pericardial
J. M. SC. 184:
752,
Effusion:
A Clinical
Study.
Am.
1032.
The authors have studied the clinical and pathologic.al data on 126 cases eontaining over 100 C.C. of pcricardial fluid found at postmortem examination over a period of ten years occurring among 95,542 cases admitted to the hospital and among 1,720 necropsies. They conc.lude that without the presence of an acute fibrous pericarditis, the diagnosis of prricardial fluid is likely to be missed unless the effusion amounts to over 500 C.C. Of the 126 cases, a correct clinical diagnosis of pericardial effusion was made only 6 times. To establish a clinical diagnosis of pericardial effusion, all signs and symptoms must be carefully looked for and analyzed and roentgen ray studies employed in all cases except a very few, where the effusion is so large and rapid in its development that the clinical diagnosis is easily made at once.