Phrenic nerve injury and diaphragmatic paralysis following pacemaker pulse generator replacement.
Diaphragmatic paralysis (DP) is a common condition. It can be unilateral or bilateral and the diagnosis is usually based on a clinical and radiological findings. Bilateral diaphragmatic paralysis is usually symptomatic with dyspnea and acute respiratory failure while unilateral diaphragmatic paralysis is typically asymptomatic and when present, symptoms usually depend on the presence of underlying pulmonary or neurologic disease. DP can be the result of various chest conditions that affect the phrenic nerve such as tumors, vascular abnormalities or traumatic incidents during surgery as well as blunt or penetrating chest or neck injuries. We report a unique case of phrenic nerve injury and unilateral diaphragmatic paralysis secondary to pacemaker pulse generator replacement that was successfully treated with diaphragmatic plication.
Department of Medicine, Staten Island University Hospital, Staten Island, New York 10305, USA. kassemharris@gmail.com
Kassem
K
Harris
Gregory
G
Maniatis
Faraz
F
Siddiqui
Theodore
T
Maniatis
D000368:Aged; D020878:Device Removal; D003937:Diagnosis, Differential; D003964:Diaphragm / Q000294:innervation* / Q000601:surgery; D005260:Female; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010791:Phrenic Nerve / Q000293:injuries*; D012133:Respiratory Paralysis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013575:Syncope / Q000628:therapy; D014057:Tomography, X-Ray Computed