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Diagnosis of Pericarditis

David H. Spodick, MD, DSc
Arch Intern Med. 1980;140(1):138-139. doi:10.1001/archinte.1980.00330130140047.
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To the Editor.  —The article entitled "Pericarditis" by Agner and Gallis, in the Archives (139:407-412,1979), is an excellent contribution to the practical diagnosis and management of this disorder. Although its epidemiologic basis is, perhaps, not entirely valid, owing to obtaining cases retrospectively from mixed sources, the data and conclusions accord with my own anecdotal experience and investigations. Therefore, I consider their analysis and conclusions to be valid—and very valuable. However, I would like to raise a terminologic point about use of "risk factors."The term "risk factors" is getting looser and looser usage even among many outstanding physicians and is coming to share with other terminology the status of trendy, but often erroneous, "vogue words."2 The authors have neatly compared certain diagnostic features of tuberculous and malignant pericarditis with those of competing diagnoses. However, factors like cardiomegaly, low voltage, hemodynamic compromise, ST changes, and echocardiographic changes are hardly risk


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