Abstract
A 50-year-old man with a history of pericardiectomy 20 years previously was referred for investigation because of fatigue and abdominal discomfort. On physical examination, he was well nourished and without distress at rest, with a heart rate of 64 bpm and blood pressure 120/70 mm Hg. Marked distension of the neck veins was noticed, and the liver was sensitive and enlarged. Precordial auscultation revealed a pericardial knock in diastole. Recording of chest vibrations (vibration resonance imaging machine, Deep Breeze Co, Or Akiva, Israel) demonstrated a diastolic pericardial knock 108 ms after aortic closure sound (Figure …
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