title: ECHO and magnetic resonance imaging in a patient with high bleeding risk and ventricular perforation: a case report and literature review.
abstract: Myocardial perforation is a complication following pacemaker implantation that may cause cardiac tamponade. We present an original case of myocardial lead perforation not complicated by acute cardiac tamponade. The patient with an acute myocardial infarct had a high bleeding risk both in the acute phase of lead insertion (anticoagulant and triple platelet anti-aggregation therapy) and after few days, the percutaneous extraction lead for the double platelet antiaggregant therapy. Torrent-Guasp's theory is considered for explaining the clinical course of patient. Echocardiography and magnetic resonance imaging (MRI) evaluation showed a diffuse pericardial non-hemorrhagic fibrinous effusion and guide the clinical management.
authors.affiliation: Department of Heart and Great Vessels Attilio Reale, Sapienza University of Rome, Italy. giovanni_truscelli@yahoo.it
authors.forename: G
authors.initials: G
authors.lastname: Truscelli
authors.forename: N
authors.initials: N
authors.lastname: Galea
authors.forename: F
authors.initials: F
authors.lastname: Barillà
authors.forename: P
authors.initials: P
authors.lastname: Pellicori
authors.forename: F
authors.initials: F
authors.lastname: Toscano
authors.forename: C
authors.initials: C
authors.lastname: Gaudio
authors.forename: I
authors.initials: I
authors.lastname: Carbone
authors.forename: C
authors.initials: C
authors.lastname: Torromeo
mesh_terms: D000368:Aged; D004452:Echocardiography / Q000379:methods; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004868:Equipment Failure; D006335:Heart Injuries / Q000209:etiology*; D006352:Heart Ventricles / Q000293:injuries*; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009203:Myocardial Infarction / Q000503:physiopathology; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D012307:Risk Factors