Left hemidiaphragm paralysis

Case contributed by Dr Henry Knipe

Presentation

Shortness of breath.

Patient Data

Age: 75
Gender: Female
Modality: X-ray

Left hemidiaphragm is markedly elevated. Cardiomegaly. Left mastectomy noted, aortic valve replacement and sternotomy wires noted. 

18 months prior

Modality: X-ray

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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Case Information

rID: 31783
Case created: 28th Oct 2014
Last edited: 2nd Sep 2015
System: Chest
Inclusion in quiz mode: Included

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