The museum has in its collection a pericardial aspiration set (1950) donated by Dr R G Emanuel. It belonged to Dr Evan Bedford, physician to the Middlesex Hospital, in charge of the cardiac department from 1933 to 1963, and the first secretary of the British Cardiovascular Society. The set consists of a glass syringe with a trocar and cannula, a three way tap, and rubber tubing.
The preferred route for pericardial aspiration was the substernal one via the xiphoid area, though the pericardium was also entered in the mid clavicular line. Prior to about 1960 the needle tip electrocardiogram was not monitored. Furthermore before echocardiography was readily available confirmation of the diagnosis would depend chiefly on the radiological appearances, especially the absence of any cardiac pulsation on fluoroscopy. Sometimes contrast material was injected into the right atrium, revealing a contrast free shadow over the lateral margin of the cardiac silhouette, or the right atrial margin was indicated with the tip of a cardiac catheter.
Chest radiograph showing a cardiac catheter with its tip against the wall of the right atrium which is outlined with contrast medium. There is a gap between the right atrial wall and the margin of the cardiac silhouette indicating the presence of a pericardial effusion. Illustration from “Diseases of the Heart” by Dr Paul Wood, 1950.