Recurrent postcardiac injury syndrome mimicking cardiac perforation following transvenous pacing: An unusual presentation.
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.
Krishnan
Mangalath N
MN
Division of Cardiology, RIPAS Hospital, Brunei Darussalam. kedaram@gmail.com
Luqman
Nazar
N
Nair
Ramachandran
R
Moncy
Oommen J
OJ
Chong
Chean L
CL
Chong
Chee F W
CF
Lau
Ngo B
NB
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*