Postoperative Rhabdomyolysis in the Bilateral Shoulder Areas After Cardiac Surgery

Area of Science:

• Medicine
• Cardiology
• Nephrology

Background:

• Rhabdomyolysis (RML) involves muscle fiber death and the release of intracellular contents into circulation.
• Postoperative RML is an uncommon complication linked to surgical factors like patient positioning and duration.
• Obesity presents unique challenges in patient management during and after surgery.

Observation:

• A 43-year-old obese male developed bilateral shoulder RML post-cardiothoracic surgery for aortic valve disease.
• The RML was suspected to be a result of patient positioning during the prolonged surgical procedure.
• This presentation occurred despite the absence of other typical RML triggers.

Findings:

• This case represents the first reported instance of postoperative RML specifically associated with patient positioning in an obese cardiac surgery patient.
• Literature review identified no prior studies correlating positioning injuries in this specific demographic with RML development.
• The findings suggest that prolonged positioning in obese patients undergoing cardiothoracic procedures may pose a risk for RML.

Implications:

• Highlights the need for careful patient positioning strategies in obese individuals during cardiothoracic surgery.
• Suggests that RML should be considered in the differential diagnosis of new-onset muscle weakness or pain postoperatively in this patient group.
• Emphasizes the importance of further research into the specific risks and preventative measures for RML in obese surgical patients.