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Pulmonary and Critical Care Pearls |

An Unusual Cause of Dyspnea in a 77-Year-Old Man*

Zoe D. Daniil; Katerina Malagari; Epaminondas G. Zakynthinos; George E. Kapotsis; Charis Roussos; Spyros A. Papiris
Author and Funding Information

*From the Department of Critical Care and Pulmonary Services (Drs. Daniil, Zakynthinos, Kapotsis, Roussos, and Papiris) and the 2nd Department of Radiology (Dr. Malagari), National and Capodistrian University of Athens, Evangelismos Hospital, Athens, Greece.

Correspondence to: Spyros A. Papiris, MD, FCCP, Associate Professor, Department of Critical Care and Pulmonary Services, 45-47 Ipsilantou St, “Evangelismos” Hospital, GR 10675, Athens, Greece; e-mail: papiris@otenet.gr



Chest. 2004;125(2):770-774. doi:10.1378/chest.125.2.770
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Extract

A 77-year-old man was referred for an evaluation of dyspnea and decreased performance with exertion. There was a 2-year history of progressive shortness of breath and a 2-month history of severe exercise intolerance. For the last year, he had also complained of neck pain. There was a 20-pack-year smoking history, but he had stopped smoking 30 years before. His medical history was unremarkable.

Buszek, MC, Szymke, TE, Honet, JS, et al (1983) Hemidiaphragmatic paralysis: an unusual complication of cervical spondylosis.Arch Phys Med Rehabil64,601-603Ciccorella, DE, Daly, BD, Celli, BR Improved diaphragmatic function after surgical plication for unilateral diaphragmatic paralysis.Am Rev Respir Dis1992;146,797-799Drachler, DH, Koepke, GW, Weg, G Phrenic nerve injury from subclavian vein catheterization: diagnosis by electromyography.JAMA1976;236,2880-2881Gierada, DS, Slone, RM, Fleishman, MJ Imaging evaluation of the diaphragm.Chest Surg Clin N Am1998;8,237-280Higgs, SM, Hussain, A, Jackson, M, et al Long term results of diaphragmatic plication for unilateral diaphragm paralysis.Eur J Cardiothorac Surg2002;2,294-297Houston, JG, Fleet, M, Cowan, MD, et al Comparison of ultrasound with fluoroscopy in the assessment of suspected hemidiaphragmatic movement abnormality.Clin Radiol1995;50,95-98Large, FR, Heywood, LJ, Flower, CD, et al Incidence and etiology of a raised hemidiaphragm function after cardiopulmonary bypass.Thorax1985;40,444-447Lisboa, C, Pare, PD, Pertuze, J, et al Inspiratory muscle function in unilateral diaphragmatic paralysis.Am Rev Respir Dis1986;134,488-492Mellem, H, Johansen, B, Nakstad, P, et al Unilateral phrenic nerve paralysis caused by osteoarthritis of the cervical spine.Eur J Respir Dis1987;71,56-58

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