title: Recurrent postcardiac injury syndrome mimicking cardiac perforation following transvenous pacing: An unusual presentation.
abstract: We report a case of recurrent postcardiac injury syndrome (PCIS) after pacemaker lead insertion. Each episode was attended by hemorrhagic pleuro-pericardial effusion with drop in hemoglobin levels leading us to consider cardiac perforation and subject the patient to surgical pericardiotomy. However, no perforation or active bleeding was detected on exploration. This unusual case illustrates the occurrence of PCIS following pacemaker lead insertion, mimicking cardiac perforation. This entity should be considered in patients who, after pacemaker lead insertion, develop pericardial and pleural effusion associated with markers of inflammation.
authors.affiliation: Division of Cardiology, RIPAS Hospital, Brunei Darussalam. kedaram@gmail.com
authors.forename: Mangalath N
authors.initials: MN
authors.lastname: Krishnan
authors.forename: Nazar
authors.initials: N
authors.lastname: Luqman
authors.forename: Ramachandran
authors.initials: R
authors.lastname: Nair
authors.forename: Oommen J
authors.initials: OJ
authors.lastname: Moncy
authors.forename: Chean L
authors.initials: CL
authors.lastname: Chong
authors.forename: Chee F W
authors.initials: CF
authors.lastname: Chong
authors.forename: Ngo B
authors.initials: NB
authors.lastname: Lau
mesh_terms: D003937:Diagnosis, Differential; D004567:Electrodes, Implanted / Q000009:adverse effects*; D005260:Female; D006335:Heart Injuries / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010490:Pericardial Effusion / Q000209:etiology*; D010996:Pleural Effusion / Q000209:etiology*; D012008:Recurrence; D013577:Syndrome; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000209:etiology*