This is the case of a 55-year-old patient admitted to the ICU after cardiac surgery to repair an ostium secundum-type interatrial communication and anomalous pulmonary venous drainage. After uneventful extubation is performed, the patient remains with hypoxemia and no alterations on the thoracic x-ray. The pulmonary ultrasound performed confirms the presence of a reduced right diaphragmatic movement compared to the left one (Video 1). Diaphragmatic excursion is measured with presence of a 16 mm reduced right excursion compared to a 60 mm left excursion (Fig. 1). These findings are consistent with right diaphragmatic paralysis associated with a probable lesion of the ipsilateral phrenic nerve during surgery. Conservative therapy with incentive spirometers is used. The patient progressed favorably until hospital discharge with persistent diaphragmatic dysfunction on the ultrasound.

Figure 1

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