Diaphragmatic spasm: a neglected cause of dyspnoea and chest pain

The study included 17 patients, 12 women and 5 men, with a recurrent symptom complex involving chest pain and dyspnoea characterized by inability to get a full breath. Some attacks had subsided spontaneously. Others had lasted hours or days. When examined by fluoroscopy during an attack, each subject was found to have a nearly maximally contracted (flat) diaphragm. In some of them the attack was promptly interrupted by a small intravenous injection of sodium amytal. In others it could be aborted by a conscious effort at full expiration. The syndrome associated with diaphragmatic spasm is discussed in comparison with other noncardiac sources of chest pain and dyspnoea.