Presentation
Shortness of breath.
Patient Data
Age: 75
Gender: Female
From the case:
Left hemidiaphragm paralysis
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Info
Left hemidiaphragm is markedly elevated. Cardiomegaly. Left mastectomy noted, aortic valve replacement and sternotomy wires noted.
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Info
Hemidiaphragm is not elevated. Note sternotomy wires and aortic valve replacement is not present.
Case Discussion
Sniff test (not shown) confirmed paralysis of the left hemidiaphragm.
Key learning points:
- incidence of phrenic nerve palsy post cardiac surgery is reported between 10-60%
- usually unilateral but very rarely may be bilateral
- diaphragm contributes the majority of total ventilatory effort and palsy can result in fatigue of other respiratory muscles and result in ventilatory failure
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