Cardiac Failure Secondary to Ineffective Bellows

The two cases to be presented demonstrate ventilatory insufficiency of the restrictive type due ,in the first instance to primary neuromuscular dysfunction and in the second to chronic pleural disease with resulting calcification and restriction of the underlying parenchyma and diaphragm. Of particular interest was the development of congestive heart failure in both of these patients. These cases represent examples of cardiac failure secondary to an ineffective bellows action of the chest cage without significant intrinsic pulmonary disease.