Phonocardiographic diagnosis of diaphragmatic flutter

A 45-year-old man was reported who experienced rapid rhythmic nodding of his head and equally rapid contractions in his epigastrium, which participated by certain psychic situations. Auscultation and phonocardiography revealed a sound with "machine" rhythmicity at a rate of 333 per minute over the lower lateral thoracic region during all cardiac phases, and a diagnosis of "diaphragmatic flutter" was established. The symptoms and signs were controlled by diazepam.