Cardiac strangulation after epicardial pacing: the importance of non-specific symptoms and a low index of suspicion.

Cardiology in the Young
Margaret L MorrisonEric Rosenthal

Abstract

Cardiac strangulation is a rare and potentially deadly complication of epicardial pacemaker implantation. A young boy presenting with chest pain and tiredness almost 7 years after pacemaker implantation was found to have cardiac strangulation. Literature review revealed 22 cases reported to date with a worrying rise in the number of reports over the past 3 years. Strangulation is associated with implantation of leads at a young age and appears to be related to somatic growth. Serial assessment with chest X-ray and echocardiogram is recommended, at least until full adult growth is attained with further coronary artery imaging reserved for symptoms or suspicious echocardiographic findings. If cardiac strangulation is diagnosed prompt replacement of the offending system is needed.

References

Oct 12, 2000·The Thoracic and Cardiovascular Surgeon·H WatanabeK Takeuchi
Mar 18, 2011·Cardiology in the Young·Abdullah AlhuzaimiWalter J Duncan
Oct 11, 2014·General Thoracic and Cardiovascular Surgery·Daiji Takeuchi, Yasuko Tomizawa
Dec 17, 2014·The Journal of Thoracic and Cardiovascular Surgery·Erick M CarrerasAndrew I M Campbell
Aug 17, 2018·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Douglas Y MahPuja Banka

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