Cardiac tamponade historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]


Cardiac tamponade is a very common emergent manifestation, which can be caused by traumatic injuries, since the emulation of the disease tracks back to centuries ago. Acknowledgment of existing pericardial is first done by hippocrates, which was continued by Galen to describing what is now known as pericardial effusion.

Historical Perspective


  • Knowledge of existence of pericardium tracks down to Hippocrates era (460 BC to 370 BC) who described it as "a small mantle surrounding the heart and containing a small amount of fluid resembling urine".[1]
  • Pericardial effusion was first observed by Galen, 600 years later, which is due to the belief of ancient Greek that heat is inviolate and can not cause disease.
  • Galen also reported heart wounds are fatal due to this sequence.[2]
  • In Renaissance era at 16th century, Ambroise Paré a French surgen reported what was considered as a delayed death due to traumatic hemopericardium, by observing a gunshot of a gentleman at a duel.
  • He reported :
    • " Awound in the heart so large as would contain one's finger, and there was much blood that poured forth upon midriff"[3]
  • Tamponade effect of pericardial effusion was described by DR.Richard Lower , a Cornish physician, in 1669:
    • “Although the fluid enclosed in the pericardium serves effectively for lubricating the surface of the heart and facilitating its movement, it sometimes happens that a profuse effusion oppresses and inundates the heart. The envelope becomes filled in hydrops of the heart; the walls of the heart are compressed by the fluid settling everywhere so that the heart cannot dilate sufficiently to receive the blood; then the pulse becomes exceedingly small, until finally it becomes utterly suppressed by the great inundation of fluid whence succeed syncope and death itself.”[4]

Landmark Events in the Development of Treatment Strategies

Impact on Cultural History

Famous Cases

  • Delayed death of Empress Elizabeth of Austria, known as Sissi.


  1. Spodick, David H. (1970). "Medical history of the pericardium". The American Journal of Cardiology. 26 (5): 447–454. doi:10.1016/0002-9149(70)90701-0. ISSN 0002-9149.
  2. Abela, George (2004). Peripheral vascular disease : basic diagnostic and therapeutic approaches. Philadelphia, Pennsylvania: Lippincott Williams & Wilkins. ISBN 0781743834.
  3. Elkin, Daniel C. (1944). "WOUNDS OF THE HEART". Annals of Surgery. 120 (6): 817–821. doi:10.1097/00000658-194412000-00001. ISSN 0003-4932.
  4. Shabetai, Ralph (2003). The pericardium. Boston: Kluwer Academic Publishers. ISBN 978-1-4020-7639-8.

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