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- Received July 5, 2011
- Accepted July 15, 2011
- Published online May 1, 2012.
A 75-year-old female patient presented to our hospital with worsening shortness of breath 2 months after undergoing a coronary artery bypass graft procedure. Chest x-ray showed marked elevation of the left hemidiaphragm, with visceral contents occupying the lower two-thirds of the left hemithorax and the heart shifted to the right (A). Computed tomographic coronary artery angiography showed marked volume loss of the left lung, with the heart displaced to the right (B). The diagnosis was confirmed with a fluoroscopic sniff test, which showed a paradoxical elevation of the paralyzed hemidiaphragm with inspiration.
Phrenic nerve injury after cardiac surgery from stretching or cooling is a common etiology (1). The patient was referred for surgical plication of the hemidiaphragm.
- Received July 5, 2011.
- Accepted July 15, 2011.
- American College of Cardiology Foundation