Diseases of the chest and the principles of physical diagnosis . SEASES OF THE PERICARDIUM, HEART, AND AORTA Hydropericardium.—This condition is not due to inflammation butis a transudate and is, as a rule, associated with effusions into the otherserous cavities. Two tvpes are recognized, namely, the passive and themechanical. The former is seen in association with dropsy due toBrights disease or scarlet fever. The latter results from pressure onthe large venous trunks by an aneurism of the aorta or mediastinaltumor or as the result of faihng compensation (Fig. 377). Morbid Anatomy.—To the les
Diseases of the chest and the principles of physical diagnosis . SEASES OF THE PERICARDIUM, HEART, AND AORTA Hydropericardium.—This condition is not due to inflammation butis a transudate and is, as a rule, associated with effusions into the otherserous cavities. Two tvpes are recognized, namely, the passive and themechanical. The former is seen in association with dropsy due toBrights disease or scarlet fever. The latter results from pressure onthe large venous trunks by an aneurism of the aorta or mediastinaltumor or as the result of faihng compensation (Fig. 377). Morbid Anatomy.—To the lesions found in the acute fibrinous form isadded an excessive amount of fluid, which may be serofibrinous, purulentor hemorrhagic in character. The primary disease m the serofibrinousform is usuallv rheumatic fever or pneumonia; in the hemorrhagic form,tuberculosis, Brights disease, mahgnant disease or scurvy; if purulent incharacter scarlet fever, pneumonia, tuberculosis, or some septic conditionsuch as puerperal fever, is the exciting cause (see Fig. 175).. Fig. 377.—Hydropericardium. 1, Esophagus. 2, Aorta. 3, Inferior vena , Liver. 5, Heart. (After Pirogoff.) Symptoms.—If the effusion supervenes upon an attack of acute fibrin-ous pericarditis its recognition is sometimes facilitated by the history ofprecordial pain and the presence of a friction rub. If, however, pain hasbeen wanting, and the friction rub has escaped detection, or the effusionhas developed insidiously, as not infrequently happens in tuberculouscases or Brights disease, its detection is notoriously uncertain. In thepresence of one of the commoner etiological factors, such as acute rheuma-tism or acute croupous pneumonia, the gradual evolution from a dryfibrinous pericarditis to pericarditis with effusion may be traced , however, the case is seen after the effusion has taken place, as com-monly happens, the recognition of the condition is extremely is probably no exaggerati
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