Subacute right ventricle perforation by pacemaker lead presenting with left hemothorax and shock

Case Reports in Cardiology
Julianne NicholsDebapriya Datta

Abstract

Cardiac perforation by pacemaker is a rare but potentially fatal complication. Acute perforations occurring within twenty-four hours of insertion of pacemaker can lead to hemopericardium, cardiac tamponade, and death. Hemothorax occurring as an acute complication of pacemaker insertion is reported but extremely rare. Previously, hemothorax and shock as a subacute complication following pacemaker insertion have not been reported. We report the case of an 85-year-old patient who presented with shock from hemothorax caused by pacemaker perforation, two weeks after insertion. Device interrogation showed normal function. Chest X-ray and echocardiogram missed lead dislocation and the diagnosis was made on computed tomogram (CT) of the chest. Following surgical repair, a new ventricular pacemaker was placed transvenously in the right ventricular septum. This case illustrates that CT scan of the chest should be performed in all patients in whom cardiac perforation by pacemaker is suspected but not diagnosed on chest X-ray and echocardiogram. Normal functioning of pacemaker on device interrogation does not exclude perforation.

References

Mar 1, 2005·Pacing and Clinical Electrophysiology : PACE·Mohammed N KhanBruce L Wilkoff
Apr 14, 2005·Pacing and Clinical Electrophysiology : PACE·Ahmet AkyolEnis Oguz
Jul 13, 2005·Pacing and Clinical Electrophysiology : PACE·Ahmed SanoussiMarc Joris
Sep 21, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Srijoy MahapatraDavid L Hayes
May 3, 2006·Pacing and Clinical Electrophysiology : PACE·Hatice SelcukSule Korkmaz
May 13, 2006·Pacing and Clinical Electrophysiology : PACE·Charles A HenriksonJeffrey A Brinker
Jan 24, 2007·Pacing and Clinical Electrophysiology : PACE·David A HirschlLinda B Haramati
Dec 26, 2008·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Maciej SterlińskiHanna Szwed
Mar 30, 2012·Archives of Medical Science : AMS·Justyna PiekarzJacek Majewski

❮ Previous
Next ❯

Methods Mentioned

BETA
X-ray

Related Concepts

Related Feeds

Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.