Acute Pericarditis [antikvár]

Preface "Disease is very old and nolhing about il lias changed. It is we who change as we learn to recognize what was lonnerly imperceptible." J. M. Charcot 1 "^he pericardium is a rather unprepossessing bit of tissue if one dissects it free and lays it out on the autopsy table. Yet, inflammatory jDrocesses of this remarkable inembrane in situ can engage the attention of surgeons and roentgenologists as well as medical physicians. The pericardial rub is one of the few pathognomonic signs in clinical medicine. Pericardial effusions can produce far-reaching physiologic alterations which inay threaten life itself. The varied manifestations of acute pericarditis can miinic so many other disorders that its spectrum of differential diagnosis is one of the widest. This applies equally to distinction among apparently isolated forms of acute pericarditis and the many forms associated with generalized disease syndromes. In evaluating and managing patients with acute pericarditis, I have long been struck by the lack of any single, integrated source of information on this subject. "Nature," it is said, "abhors a vacuum," and the present volume is an attempt to side with nature in this respect. My intention has been to present acute pericarditis from the viewpoint of the clinician but with considerable emphasis upon basic concepts and their application to diagnosis antl management. Part I deals with the pericardium, the pathology antl pathologic physiology of pericardial inflammation and the physical, electrical, roentgen and humoral manifestations of acute pericarditis. A deliberate distinction has been made between irank cardiac tamponade and pericardial effusion in which cardiac compression is not detectable or is adequately compensated by circulatory adjustments, although it is recognized that the difference is one of degree within the same phenomenon. Part II describes the particular features of the individual etiologic forms of acute pericarditis. While primarily concerned with a clinical presentation, I have tried throughout to make this a "fact book" and a reference source without overly compromising its literary palatability.