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Unilateral Paralyzed Hemidiaphragm (UPD)

Laura B Bishop, M.D. Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Often an incidental finding on chest radiograph

  • It may not cause resting pulmonary symptoms unless there is underlying comorbidity such as COPD, cardiac disease, muscular weakness, ob...

DIAGNOSIS

HISTORY

  • Patients may be asymptomatic at rest.

  • Dyspnea on exertion/decreased exercise tolerance to previous activities - may be mild to severe unless patient has other underlying pulmonary dise...

TREATMENT

GENERAL MEASURES

  • Depends on the underlying cause and in the presence of nocturnal hypoventilation

  • Metabolic disturbances: Correct electrolyte and/or hormonal imbalances.

  • Nocturnal hypoventilati...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Patient monitoring up to 3 years for possible recovery

  • Periodic/serial chest films

  • Monitor for stability of lung function with serial pulmonary fu...

REFERENCES

1
Benditt  JO, Boitano  LJ. Pulmonary issues in patients with chronic neuromuscular disease. Am J Respir Crit Care Med.  2013; 187(10): 104...

ADDITIONAL READING

McCool  FD, Tzelepis  GE. Dysfunction of the diaphragm. N Engl J Med.  2012; 366(10): 932– 942. 

CODES

ICD10

J98.6 Disorders of diaphragm 

SNOMED

64228003 paralysis of diaphragm (disorder) 

CLINICAL PEARLS

  • Often an incidental finding with chest radiograph

  • Dyspnea on exertion/decreased exercise tolerance may be mild to severe unless patient has other underlying pulmonary disease (asthma, C...

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