Left hemidiaphragm paralysis

Case contributed by Dr Henry Knipe

Presentation

Shortness of breath.

Patient Data

Age: 75
Gender: Female
X-ray

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

X-ray

18 months prior

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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