Match each post-operative cardiothoracic surgery complication to its characteristic clinical presentation or diagnostic finding.
- Phrenic nerve injuryElevated hemidiaphragm with paradoxical motion during the sniff test
- Thoracic duct injuryMilky-appearing pleural effusion with a fluid triglyceride level greater than 110 mg/dL
- Recurrent laryngeal nerve injuryNew-onset hoarseness with unilateral vocal cord paralysis on laryngoscopy
- Postpericardiotomy syndromeFever, pleuritic chest pain, and a pericardial friction rub developing weeks after surgery
Answer
Phrenic nerve injury pairs with elevated hemidiaphragm; Thoracic duct injury pairs with milky pleural effusion; Recurrent laryngeal nerve injury pairs with new-onset hoarseness; Postpericardiotomy syndrome pairs with late-onset fever and friction rub.
Each complication has a distinct anatomical or physiological basis directly tied to the surgical field: the phrenic nerve controls the diaphragm, the thoracic duct transports triglyceride-rich chyle, the recurrent laryngeal nerve controls the vocal cords, and the pericardium can undergo a delayed autoimmune inflammatory response.
Step-by-Step Solution
Key Concept
Recognition of common anatomical and physiological complications following cardiothoracic surgery.