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(Chest. 1974;66:193-195.)
© 1974 American College of Chest Physicians

Alternans of Loud Midsystolic Clicks: A Unique Finding in Massive Pericardial Effusion

Tali Bashour M.D.1; Raul Hemb M.D.2; Nayab Ali M.D.3; and Joseph Lindsay Jr. M.D.4

1 Assistant Professor of Medicine, The George Washington University School of Medicine
2 The George Washington University Medical Center
3 Assistant Professor of Medicine, Howard University School of Medicine
4 Professor of Medicine, The George Washington University School of Medicine

In a patient with massive pericardial effusion, alternating loud midsystolic clicks were recorded in association with prominent electrical alternans. Both disappeared after removal of pericardial fluid. Possible extracardiac or mitral origin of the clicks is discussed and their close relation to electrical alternans is considered as supportive evidence of pendular movement of the heart in cases of pericardial effusion.






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Copyright © 1974 by the American College of Chest Physicians.