Abstract
Unusual, hitherto undescribed form of, diastolic heart beat was reported in a case of tense pericardial effusion and in another case of seroconstrictive pericarditis. It consists of large and sharp early diastolic thrust, the peak of which conincides in time with the protodiastolic extrasound (pericardial knock). The mechanism and the diagnostic significance were discussed. Failure to recognize this diastolic heart beat in most cases of pericardial effusion or seroconstrictive (effusive-constrictive) pericarditis may be due to the absolute faintness of the precordial movement in these conditions. In addition, inspiratory widening of the split second heart sound due to the shortened electromechanical systole was described in a case of tense pericardial effusion without constriction
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