Paroxysmal flutter of the diaphragm

A report of five cases
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      Five cases of diaphragmatic flutter are presented. In 2 patients the fluttering episodes were chronic and recurrent; the others had isolated or sporadic attacks. The paroxysms of diaphragmatic flutter were associated with great subjective distress in each patient, but serious clinical sequelae did not occur. In 1 patient with pre-existing obstructive emphysema, however, carbon dioxide retention was observed during fluttering. Possible psychosomatic factors in etiology were noted in each case.
      Flutter of the diaphragm was confirmed by fluoroscopy and/or electrocardiogram in all subjects. The rate and rhythm of fluttering, amplitude, and symmetry of diaphragmatic motion were highly variable.
      Comments are made on the physiologic measurements and electrocardiograms in the disturbance.
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