RECENTLY, 14 white male patients were admitted to this hospital with myocardial failure accompanied by pericardial effusion. The favorite beverage of each was beer.
We had not previously encountered pericardial effusion in "alcoholic myocardopathy."1,2 The large globular heart shadow seen on x-ray film in myocardopathies suggests pericardial fluid,2-4 but its presence has been rarely documented.3,4 It is the purpose of this report to emphasize this feature which was present in 14 patients. These men presented a slightly different picture from others with myocardopathy.5,6
The patients, mostly middle-aged, usually lived alone, ate sporadically, often worked as part-time bartenders, and admitted to drinking or were reputed to drink beer continuously during the waking hours.
Edema was frequently massive, and often preceded dyspnea. The latter was gradual in onset and often did not prompt hospitalization until it was very distressing and orthopnea intervened. A plethoric, cyanotic appearance was common. Neck veins were markedly