By late ppotemenam vpotny pericardita are signs sdavljenia the mediastinum. Pressure pericardialland effusion in the box can be one of the reasons for the persistence of "lauschego" dry cough. Sdavljenie digestive results in the prevention of glotania, pressure on the left back guttural nerve-change vote. Owing to the restrictions on the mobility of the diaphragm are getting out of breath stomach (Vinters sign). One of the signs of fluid accumulation in the cavities pericardialna believe dissociatia pulse and heart verhusherngo sufficiently complete pulse with a weak start. More often, however, верхушечный a boost even if перикарде large quantities of liquid, although painting on the left lower limit перикардиальной Center (sign Жандрена) above its normal situation. He is the third-quarter mejreberie knutri of sredinno-klucicna line instead chetvertogo-patogo mejreberia normal. As tampondy cepdza increasingly pronounced a circulatory disorders, it expressed tachycardia, filling rate decreases. At times there alterniruty pulse. Falls AD, especially pulsovoe. Filling pulse when inhaling declining, a phenomenon explored Kussmaulem and Traube, and received a paradox pulse. Dobrotworski A. (1884) described in vpotnom pericardite the differential pulse. The higher it внутриперикардиально e pressure, the higher rates of venous pressure (200 mm waters. Art. and more) are registered. The swelling and peripheral leg veins. Characteristically, pulsation neck veins were not for inhaling filling increasing. Paradoxically pulse and swelling of inhaling cervical veins Kussmaul described as a double inspiratornyi phenomenon. Momentum lips to the concerns sinushnostew lips, nose, ears. Swelling person can be greatly raised, forming a symptom of "consular head", "Stokes opponent." It also develops swelling shoulder and hands priority overflow veins and синюшность one hand, the increasingly left-hand (left сдавление wrists). More and becomes painful palpation in the liver, especially the left. Liver appears earlier than peripheral oedema. Since some provisions of a partial unloading the upper basin with the vena cava, the patient rising tampondoy heart is characteristic of dosteli : he sits, torso tilts forward, striking it relied on a pillow (Breitmana runs), or is on its knees and contact person and back to the boat. If the tampondy the heart attack patient suffered bouts of weakness accompanied by small, barely visible pulse, the patient is fearful of death. Leather covered with a cold myself then zianoz growing, cold limbs. At times, the patient loses consciousness. Ekssoudativee form only occasionally lead to tamponade and forced to re puncciam. In other cases, the process of transformation in the predominantly adgezivny, sdavlivati. In the absence of complications during vpotny pericardita is sound.