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Idiopathic bilateral diaphragmatic dysfunction as a cause of dyspnea

Diaphragmatic paralysis is an unusual and often underrecognized cause of dyspnea. We present a case of bilateral diaphragmatic paralysis with no identifiable etiology. Our patient is a 73-year-old female with a history of smoking who presented with dyspnea and orthopnea. She was treated for obstruct...

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Autores principales: MacBruce, D, Safdar, S, Katpally, K, Shaaban, Hamid, Adelman, M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857574/
https://www.ncbi.nlm.nih.gov/pubmed/27186002
http://dx.doi.org/10.4103/0970-2113.180919
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author MacBruce, D
Safdar, S
Katpally, K
Shaaban, Hamid
Adelman, M
author_facet MacBruce, D
Safdar, S
Katpally, K
Shaaban, Hamid
Adelman, M
author_sort MacBruce, D
collection PubMed
description Diaphragmatic paralysis is an unusual and often underrecognized cause of dyspnea. We present a case of bilateral diaphragmatic paralysis with no identifiable etiology. Our patient is a 73-year-old female with a history of smoking who presented with dyspnea and orthopnea. She was treated for obstructive lung disease with no improvement in dyspnea despite adequate therapy. She had pulmonary function tests (PFTs) that revealed marked decrease in vital capacity and was unable to perform lung volume maneuvers supine due to marked dyspnea. The maximal inspiratory pressure was 37 in the upright position and decreased to 27 in the supine position. She was given a presumptive diagnosis of idiopathic bilateral diaphragmatic dysfunction. Given the history, physical exam, and PFT findings, we felt that the patient did not need further invasive testing. The patient was treated with noninvasive mechanical ventilation due to hypercapnia and her symptoms improved.
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spelling pubmed-48575742016-05-16 Idiopathic bilateral diaphragmatic dysfunction as a cause of dyspnea MacBruce, D Safdar, S Katpally, K Shaaban, Hamid Adelman, M Lung India Case Report Diaphragmatic paralysis is an unusual and often underrecognized cause of dyspnea. We present a case of bilateral diaphragmatic paralysis with no identifiable etiology. Our patient is a 73-year-old female with a history of smoking who presented with dyspnea and orthopnea. She was treated for obstructive lung disease with no improvement in dyspnea despite adequate therapy. She had pulmonary function tests (PFTs) that revealed marked decrease in vital capacity and was unable to perform lung volume maneuvers supine due to marked dyspnea. The maximal inspiratory pressure was 37 in the upright position and decreased to 27 in the supine position. She was given a presumptive diagnosis of idiopathic bilateral diaphragmatic dysfunction. Given the history, physical exam, and PFT findings, we felt that the patient did not need further invasive testing. The patient was treated with noninvasive mechanical ventilation due to hypercapnia and her symptoms improved. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4857574/ /pubmed/27186002 http://dx.doi.org/10.4103/0970-2113.180919 Text en Copyright: © Lung India http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
MacBruce, D
Safdar, S
Katpally, K
Shaaban, Hamid
Adelman, M
Idiopathic bilateral diaphragmatic dysfunction as a cause of dyspnea
title Idiopathic bilateral diaphragmatic dysfunction as a cause of dyspnea
title_full Idiopathic bilateral diaphragmatic dysfunction as a cause of dyspnea
title_fullStr Idiopathic bilateral diaphragmatic dysfunction as a cause of dyspnea
title_full_unstemmed Idiopathic bilateral diaphragmatic dysfunction as a cause of dyspnea
title_short Idiopathic bilateral diaphragmatic dysfunction as a cause of dyspnea
title_sort idiopathic bilateral diaphragmatic dysfunction as a cause of dyspnea
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857574/
https://www.ncbi.nlm.nih.gov/pubmed/27186002
http://dx.doi.org/10.4103/0970-2113.180919
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