James Hope in his book titled A Treatise on the Diseases of the Heart and Great Vessels described two signs he believed to be important to support the diagnosis of adherent pericardium in rheumatic heart disease:
Josef Skoda described three patients with an adherent pericardium associated with systolic depression and diastolic elevation at the intercostal spaces to the left of the apical heart beat:
In all the cases there is a definite history of pericarditis, and in three of them there are other conditions strongly suggesting an adherent pericardium. (20, p.
A post-mortem examination showed that the cause was adherent pericardium. (21, p.
In cases of large heart with adherent pericardium there is a considerable area of the ventricles closely adherent to the central tendon of the diaphragm, and the powerful contraction of the hypertrophied heart must give a decided tug to this structure.