Osler revisited: an unusual cause of inversion of the diaphragm

Osler described depression of the left hemidiaphragm and left lobe of the liver as a physical finding in some patients with pericardial effusion. Inversion of the left hemidiaphragm associated with a large pericardial effusion is an unusual, previously unreported complication. It may be a contributory factor in the production of unexplained dyspnea in some patients.