Iatrogenic Microperforation Linked to Hemorrhagic Pericardial Effusion Complicated by Cardiac Tamponade

Pericardial effusions have a wide range of etiologies, including infection, inflammation, and malignancy. A complication of pericardial effusion is cardiac tamponade. In instances of cardiac tamponade, prompt echocardiography and stabilization are paramount in preventing mortality. Here, we report a case of iatrogenic microperforation of the right ventricle during a pacemaker lead adjustment causing a delayed pericardial effusion complicated by cardiac tamponade. Lead removal is recommended in cases of valvular endocarditis, pocket infection, thrombosis, or life-threatening dysrhythmias; however, there are no established guidelines in the setting of perforation. In this case, an emergent pericardiocentesis was performed due to cardiac tamponade, but lead extraction was not performed.