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Images in thorax
A deadly web
  1. Alexandra M Nanzer1,
  2. Simon Jordan2,
  3. Simon Padley3,
  4. Mark Griffiths4,
  5. Matthew Hind1
  1. 1Department of Respiratory Medicine, Royal Brompton Hospital, London, UK
  2. 2Thoracic Surgery, Royal Brompton Hospital, London, UK
  3. 3Department of Radiology, Royal Brompton Hospital, London, UK
  4. 4Adult Intensive Care Unit, Royal Brompton Hospital, London, UK
  1. Correspondence to Dr Alexandra Nanzer, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London SW1 6NP, UK; A.Nanzer-Kelly{at}rbht.nhs.uk

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An 18-year-old patient with metabolic myopathy due to long-chain fatty acid coenzyme A dehydrogenase-deficiency1 ,2 presented with worsening positional dyspnoea. He had required invasive ventilation via tracheostomy 6 months earlier. Examination revealed respiratory distress, a prolonged inspiratory phase and …

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