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DIAPHRAGMATIC FLUTTER WITH SYMPTOMS OF ANGINA PECTORIS

WILLIAM B. PORTER, M.D.
JAMA. 1936;106(12):992-994. doi:10.1001/jama.1936.02770120024006.
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Diaphragmatic "tic" is sufficiently rare to justify one in reporting an authenticated example of this peculiarly interesting malady.

The case to be reported is unique in that the movement of the minor contractions was recorded graphically and the rate was found to be 300 or more per minute, and a study of the diaphragm under the fluoroscope showed that the contractions were bilateral, spread over the entire diaphragm and apparently rhythmic in time and amplitude. The term "diaphragmatic flutter" is most appropriate and descriptive of the observed phenomenon.

There was associated with the disturbance of diaphragmatic function severe pain in the left pectoral muscle and in the left arm and hand over an area corresponding to the eighth cervical and the first, second and third dorsal segments of the cord (fig. 1). Over the area of referred pain there was marked hyperesthesia, which persisted even after relief from pain followed

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