Diagnosis of Pericardial Effusion by Intravenous Atriography

THE diagnosis of pericardial effusion and pericarditis is often difficult. The history and physical signs can be misleading, and the electrocardiogram is frequently equivocal. A high index of suspicion is necessary if the diagnosis is not to be missed though recognition becomes easier in the presence of typical central chest pain together with a friction rub synchronous with the heartbeat, and the presence of a known pathogenic agent – for example, infection or tumor. Effusion may be from many causes, but the commonest encountered are infections and tumors of the mediastinum, particularly bronchial carcinoma and the reticuloses. When the fluid . . .