Post-operative shortness of breath

Clinical introduction A previously well 34-year-old woman presented to the ED in the evening following an elective arthroscopy of her right shoulder and removal of a paralabral cyst. She had undergone a general anaesthetic and right interscalene nerve block, and the operation had gone well. She presented with chest ‘heaviness’ and shortness of breath immediately postoperatively which failed to resolve upon returning home and so she had returned to the ED. Auscultation of her chest was normal, RR was 18  breaths per minute and oxygen saturations were 99% on room air. ECG showed normal sinus rhythm at 72 beats per minute. Her chest X-ray (CXR) is shown in figure 1. Question What is the most likely diagnosis?Pulmonary embolism Right basal atelectasis Phrenic nerve palsy Post-operative pneumonia Answer: C The CXR shows a raised right hemidiaphragm—this is most likely...
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: EMJ Image Challenge Source Type: research