PERICARDITIS WITH EFFUSION: NEW OBSERVATIONS, WITH A NOTE ON EWART'S SIGN
Authors: I STEINBERG
Journal: Annals of Internal Medicine (1958)

Case Reports1 August 1958PERICARDITIS WITH EFFUSION: NEW OBSERVATIONS, WITH A NOTE ON EWART'S SIGNISRAEL STEINBERG, M.D., F.A.C.P.ISRAEL STEINBERG, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-49-2-428 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRecent observations following angiocardiography in patients with pericardial effusions reaffirm that small effusions accumulate in the infracardiac diaphragmatic portion of the pericardial sac. With larger effusions, the fluid next accumulates anteriorly in the retrosternal area because of fixation of the pericardium to the great vessels above, and by the inferior vena cava as it pierces the diaphragm below. With massive effusions, the lateral pericardial pouches become distended. In light of this information, a note concerning Ewart's sign and thoracic paracentesis through the posterior approach seems warranted.Ewart in 1896,1and Pins2before him, called attention to the presence of an...Bibliography1. Ewart W: Practical aids in the diagnosis of pericardial effusion, in connection with the question as to surgical treatment, Brit. M. J. 1: 717-721, 1896. CrossrefMedlineGoogle Scholar2. Pins E: A new symptom of pericarditis, Wien. med. Wchnschr. 34: 209, 1889. Google Scholar3. WilliamsSteinberg RGI: The value of angiocardiography in establishing the diagnosis of pericarditis with effusion, Am. J. Roentgenol. 61: 41-44, 1949. Google Scholar4. LevyFowlerJacobsLeckertIrionRosenChastant LRHJJIH: Angiocardiographic confirmation of pericardial effusion, Am. Heart J. 43: 59-66, 1952. CrossrefMedlineGoogle Scholar5. GevaltLevine FCSA: The significance of Ewart's sign, Internat. Clin. 4: 1-5, 1940. Google Scholar6. Levine SA: Clinical heart disease, 4th Ed., 1951, W. B. Saunders Company, Philadelphia. CrossrefGoogle Scholar7. FenichelEpstein NMBS: The clinical and roentgenologic diagnosis of pericardial effusion, Ann. Int. Med. 24: 401-412, 1946. LinkGoogle Scholar8. GoldbergEngle HPMA: Personal communications. Google Scholar9. ChapmanAnderson EMRG: Aids in physical diagnosis: signs over the lower left lung caused chiefly by cardiac enlargement, Ann. Int. Med. 23: 35-40, 1945. LinkGoogle Scholar10. Connor LA: On the diagnosis of pericardial effusion, with special reference to physical signs on the posterior aspect of the thorax, Am. Heart J. 1: 421-433, 1926. Google Scholar11. Curschmann H: Zur Beurteilung und operativen Behandlung grosser Herzbeulergüsse, Deutsche Klin. 15: 401, 1907. Google Scholar12. Sutton LP: Pericarditis with effusion, Am. J. Dis. Child. 41: 78-88, 1931. Google Scholar13. Sutton LP: Thoracentesis of the pericardium as a therapeutic measure, Am. J. Dis. Child. 48: 44-56, 1934. Google Scholar14. Williamson CS: Pericarditis with effusion: an experimental study, Arch. Int. Med. 25: 206-228, 1920. CrossrefGoogle Scholar15. Sauerbruch F, quoted by Freedman, E.: Inflammatory diseases of the pericardium, Am. J. Roentgenol. 42: 38-46, 1939. Google Scholar16. Fleischner F: Perikarderguss, Fortschr. Röntgenstrahl. 38: 402, 1928. Google Scholar17. Roessler H: Clinical roentgenography of the cardiovascular system, 2nd Ed., 1943, Charles C Thomas, Springfield, Illinois. Google Scholar18. Golden R: Pericardial effusion in the lateral roentgenogram: a preliminary report, Am. J. Roentgenol. 64: 127, 1950. Google Scholar19. BestermanThomas EMGI: Radiological diagnosis of rheumatic pericardial effusion, Brit. Heart J. 15: 113-120, 1953. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ISRAEL STEINBERG, M.D., F.A.C.P.Affiliations: New York, N. Y.*Received for publication July 15, 1957.From the Department of Radiology, The New York Hospital-Cornell Medical Center.†Aided by a grant from the Mallinckrodt Chemical Works.Requests for reprints should be addressed to Israel Steinberg, M.D., The New York Hospital, 525 East Sixty-eighth Street, New York 21, N. Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTension Pneumopericardium During Positive-Pressure Ventilation Leading to Cardiac ArrestFunktion des Perikards für die Pumpleistung des Herzens unter physiologischen und pathologischen BedingungenStumpftraumatische Schäden des Herzens und der großen herznahen GefäßeAcute cardiac tamponade pathologic physiology, diagnosis and managementPericarditisElectric alternation of the heartRoentgenography of pericardial diseaseErkrankungen des Perikard 1 August 1958Volume 49, Issue 2 Page: 428-437 Keywords Angiocardiography Aorta Diagnostic radiology Inferior vena cava Pericardium Thorax ePublished: 1 December 2008 Issue Published: 1 August 1958 PDF downloadLoading ...