title: Atypical presentation of bilateral phrenic nerve palsy and its unusual recovery after coronary artery bypass grafting.
abstract: Bilateral phrenic nerve paralysis after coronary artery bypass surgery in a 47-year-old female patient is reported. This became evident on the 5th post-extubation day and mimicked acute coronary syndrome and led to difficulty in diagnosis. The patient required re-intubation and mechanical ventilation for only 6 days. The diagnosis of clinical and radiological abnormalities suggestive of bilateral phrenic nerve dysfunction was assisted by fluoroscopy, measurement of needle electromyography, and phrenic nerve motor conduction studies. The patient was followed up postoperatively for 14 weeks with complete regression of the neuropathy one month after surgery. An awareness of this complication should lead to improved care and successful postoperative management of patients.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. rajnishduara@rediffmail.com
authors.forename: R
authors.initials: R
authors.lastname: Duara
authors.forename: A K
authors.initials: AK
authors.lastname: Sarma
authors.forename: P K
authors.initials: PK
authors.lastname: Sinha
authors.forename: R
authors.initials: R
authors.lastname: Ashalatha
authors.forename: M
authors.initials: M
authors.lastname: Misra
mesh_terms: D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003327:Coronary Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D006801:Humans; D008875:Middle Aged; D009431:Neural Conduction; D010243:Paralysis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D010791:Phrenic Nerve; D011859:Radiography