Hemopericardium caused by a mobile retained epicardial pacing wire after ventricular septal defect repair: A case report.
BACKGROUND
Epicardial pacing wires (EPWs) are commonly employed for diagnosis and treatment of arrhythmia in the acute phase after cardiac surgery. Although rare, retained EPWs may cause mild-to-catastrophic complications. The present case demonstrates hemopericardium caused by a mobile retained EPW.


METHODS
A 49-year-old woman presented to our emergency department with clinical signs of impending cardiac tamponade. She had undergone ventricular septal defect repair 7 years before this admission. An initial computed tomography (CT) scan revealed hemopericardium with suspicion of a possible intracardiac lesion. Review of the first and second CT scans, however, revealed a mobile retained EPW penetrating the pericardium in the first scan, which had moved out of the pericardium in the second scan.


RESULTS
Because cardiac injury by the EPW was suspected, the patient was transferred to another medical center for further treatment.


CONCLUSIONS
According to our experience with this case, diagnosis may be incorrect if CT is unable to obtain decisive images of the mobile EPW at the correct time. Multiplanar reconstruction and volume rendering can increase diagnostic accuracy. In conclusion, if hemopericardium is present without clear etiology in a patient with a retained EPW, a nearby mobile EPW may be the cause.
aDepartment of Diagnostic Radiology, Chang Gung Memorial Hospital, Puzi City, Chiayi County bDepartment of Physical Education, Health and Recreation, National Chiayi University, Chiayi City cChang Gung University College of Medicine, Taoyuan dDepartment of Cardiology, Chang Gung Memorial Hospital, Puzi City, Chiayi County eDepartment of Diagnostic Radiology, Antai Tian-Sheng Memorial Hospital, Pingtung, Taiwan.
Li-Sheng
LS
Hsu
Jen-Te
JT
Hsu
Min-Lang
ML
Chen
Chien-Lin
CL
Liao
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004562:Electrocardiography; D004567:Electrodes, Implanted / Q000009:adverse effects*; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology*; D010496:Pericardium; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed
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