Pseudodyskinesis--a novel mechanism for abnormal motion of the heart's diaphragmatic wall

We report a case of pseudodyskinesis, where there is dyssynchronous contraction of the heart's diaphragmatic wall despite normal wall thickening. This finding has previously been reported in a small group of patients with liver disease, and has been attributed to elevation of the diaphragm as a result of hepatomegaly and ascites. Our case demonstrates similar findings in a patient without liver disease, in whom the diaphragm was elevated secondary to volume loss in the chest. Our case supports the assertion that diaphragmatic elevation, regardless of cause, is indeed responsible for this probably common echocardiographic finding.