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Pacemaker Lead Migration and Ventricular Perforation in a Patient Presenting with Chest Pain

CASE PRESENTATION: We describe a middle-age male with a past medical history of second-degree atrioventricular block type II status post permanent pacemaker placement the day prior who presented to the emergency department complaining of chest pain. Electrocardiography showed a non-paced ventricular...

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Detalles Bibliográficos
Autores principales: Cañizares-Otero, Maria C., Danckers, Mauricio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610481/
https://www.ncbi.nlm.nih.gov/pubmed/34813451
http://dx.doi.org/10.5811/cpcem.2021.7.52689
Descripción
Sumario:CASE PRESENTATION: We describe a middle-age male with a past medical history of second-degree atrioventricular block type II status post permanent pacemaker placement the day prior who presented to the emergency department complaining of chest pain. Electrocardiography showed a non-paced ventricular rhythm. Chest radiograph showed the ventricular pacemaker lead located distally overlying the right ventricle apical area. On further investigation, chest computed tomography showed a perforation of the ventricular wall by the pacemaker lead prompting urgent intervention by the cardiothoracic surgery team for lead replacement and right ventricular repair. DISCUSSION: Our case illustrates the importance of timely recognition of a perforated pacemaker lead in a patient presenting with chest pain after device implantation. We additionally describe the risk factors for ventricular perforation, initial clinical presentation, and management approach.