Right atrial thrombus secondary to pacemaker wires.
BACKGROUND
Pacemaker-induced right atrial thrombus is a rare condition that has not been described in the Emergency Medicine literature. This is a potentially fatal condition that is diagnosed with an echocardiogram and treated with surgical removal, thrombolytics, or long-term anticoagulation.


OBJECTIVE
This case report is designed to increase awareness among emergency physicians of this potentially fatal condition.


METHODS
We describe the case of a patient with a massive right atrial thrombus secondary to pacemaker wire who presented to the Emergency Department with syncope, bradycardia, and rapid hemodynamic deterioration.


CONCLUSIONS
Emergency physicians should be aware of this life-threatening entity. Emergency bedside cardiac ultrasound or echocardiogram may be of value in its early identification.
Feuchter
Alexander C
AC
University of Pittsburgh Affiliated Residency in Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Katz
Kenneth D
KD
D000368:Aged; D001919:Bradycardia / Q000209:etiology; D017809:Fatal Outcome; D006325:Heart Atria / Q000473:pathology*; D006331:Heart Diseases / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D013575:Syncope / Q000209:etiology; D013927:Thrombosis / Q000209:etiology / Q000473:pathology*