Case 9: Interscalene Block a Concern in Cardiac Patients?
An 83-year-old man (81 kg and 172 cm) is scheduled for an elective right shoulder arthroscopy with rotator cuff tear repair. His past medical history is significant for coronary artery disease. He has had two prior coronary artery bypass surgeries, the latest 12 years ago. Hypertension and hyperlipidemia are well controlled. On questioning, he denies any symptoms of chest pain or shortness of breath with exertion. EKG shows normal sinus rhythm and a right bundle branch block. A stress echocardiogram performed 2 weeks ago showed a normal ejection fraction with no signs of ventricular wall motion abnormalities. His oxygen saturation is 97% and his vital signs are normal. A chest X-ray was not ordered as his chest exam is normal except for decreased air entry at the base of the right lung.
KeywordsInterscalene block Pulmonary function Chilaiditi’s sign
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