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Case report
Chronic intercostal neuralgia after placement of right ventricle to pulmonary artery conduit with prosthetic valve
  1. Destiny F Chau1,
  2. Eudice E Fontenot2 and
  3. Michael L Schmitz1
  1. 1Anesthesiology/Pediatric Cardiothoracic Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  2. 2Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  1. Correspondence to Dr Destiny F Chau; dchau{at}uams.edu

Abstract

Adults with congenital heart disease often have complex medical issues requiring individualised multidisciplinary care for optimising outcomes and quality of life. Chronic pain is an example. We report a rare case of intercostal neuralgia seemingly caused by irritation from a prosthetic valve in a right ventricle to pulmonary artery conduit in a patient with tetralogy of Fallot. Intercostal neuralgia is a painful disorder linked to nerve irritation or injury from trauma, infection or pressure. Although chronic postsurgical pain after cardiac surgery is prevalent, rarely the aetiology relates to valve irritation on a single intercostal nerve. After failing pharmacological therapy for 8 months, the neuralgia completely resolved after an ultrasound-guided neurolytic block with long-term effectiveness and improvement in patient satisfaction.

  • pain
  • pain (neurology)
  • cardiovascular medicine
  • medical management
  • cardiothoracic surgery

https://doi.org/10.1136/bcr-2020-239264

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    Footnotes

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    • Contributors All authors made substantial contributions to the creation of this report, the acquisition of the details, the analysis and discussion of the case; also, to the drafting and revision of important intellectual content. All authors gave final approval of the version published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.