Diaphragmatic paralysis in patients with respiratory insufficiency compounds the problems in the management. In the presence of lower lobe atelectasis, pleural effusion, or a patient's poor respiratory effort, fluoroscopic examination is often not a reliable way to diagnose diaphragmatic paralysis. We observed that transcutaneous phrenic nerve stimulation in the neck and recording the diaphragm...

DESCRIPTION A 69-year-old man presented with mild, but limiting exertional breathlessness. He had undergone an elective direct current (DC) cardioversion for atrial fibrillation 7 days previously. A chest radiograph performed by the cardiology team showed a raised right hemi-diaphragm (figure 1). A chest radiograph performed 6 months before had been normal. Symptoms and radiographic changes wer...

Fifty infants and 50 children less than 15 years undergoing palliative or corrective cardiac surgery in the Brompton Hospital between March and October 1988 had direct percutaneous stimulation of the phrenic nerve before and after operation. Ten patients, six under 1 year of age and four over, developed unilateral phrenic nerve injury. In those aged less than 1 year recovery after operation was...

INTRODUCTION Idiopathic phrenic nerve palsy is a rare cause of exertional dyspnea. We present a case of a patient presenting with worsening dyspnea of an unknown etiology found to be related to bilateral phrenic nerve palsy. DISCUSSION Forty-two-year-old man presented to our emergency department with exertional dyspnea, orthopnea, and a left lower lobe consolidation treated initially as bronc...

A 69-year-old man with a history of severe nonischemic cardiomyopathy managed with a cardiac resynchronization-defibrillator presented to the outpatient clinic with uncomfortable pulsation over the left upper-abdominal area when lying on his left side. He was hemodynamically stable. When he was recumbent in a left-lateral position, there were visible and palpable contractions of the left upper-...

Phrenic nerve injury can occur as a complication of lung transplantation. A 54-year-old man underwent single-lung transplantation due to interstitial pneumonia. The patient required circulatory support with venoarterial extracorporeal membrane oxygenation and was unable to be weaned from ventilatory support with nitric oxide. Although enhanced CT scanning showed stenotic anastomosis of the righ...

A 64 year old gentleman with cervical spondylosis presented with sudden onset breathlessness associated with significant orthopnea. On clinical examination he had decreased power in his upper extremities with reduced chest excursion. Cervical spine MRI revealed severe spondylosis at multilevel with evidence of cord compression. Chest x ray showed elevated left diaphragm and sniff test confirmed...

background: cardiovascular disease is an important non-obstetric cause of maternal and fetal /neonatal morbidity and mortality during pregnancy. for a pregnant woman with cardiac disease, the potential inability of the maternal cardiovascular system to contend with normal pregnancy-induced physiologic changes may produce deleterious effects on both mother and fetus. to determine the most freque...

conclusions comparing the serum lactate level before operation and 24 hours after the operation showed that the number of received blood units had a significant effect on serum lactate. we found no significant effect for blood storage duration; however, the number of given blood units was more significant. patients and methods in a cross-sectional study, 228 patients referred to three hospitals...

Congenital diaphragmatic hernia (CDH) is a developmental anomaly characterized by the malformation of the diaphragm and impaired lung development. In the present study, we tested several hypotheses regarding the pathogenesis of CDH, including those suggesting that the primary defect is due to abnormal 1) lung development, 2) phrenic nerve formation, 3) developmental processes underlying diaphra...