Key result
A 74-year-old male developed right ventricular perforation and acute pericardial tamponade three weeks after dual chamber pacemaker insertion, requiring emergent pericardial window creation.
Case Report (n=1)
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Cardiac perforation is a rare but life-threatening complication of pacemaker insertion that can present subacutely and requires prompt echocardiographic diagnosis and surgical intervention.
A 74-year-old male with tachy-brady syndrome underwent a dual chamber pacemaker insertion. Three weeks after the procedure, the patient presented with dyspnea, melena and hypotension refractory to intravenous hydration and blood transfusion. An echocardiogram revealed a normal ejection fraction and a large pericardial effusion with impending tamponade that required emergent transportation to a tertiary care facility. An echocardiogram done at the tertiary care facility showed a large pericardial effusion with cardiac tamponade, thrombus overlying the right ventricle, which were consistent with right ventricular perforation induced by pacemaker insertion. The emergent pericardial window was created and 850 mL of blood was drained.
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Patel et al. (2016) conducted a case report in Right ventricular perforation and pericardial tamponade (n=1). Dual chamber pacemaker insertion was evaluated on Right ventricular perforation and pericardial tamponade. A 74-year-old male developed right ventricular perforation and acute pericardial tamponade three weeks after dual chamber pacemaker insertion, requiring emergent pericardial window creation.
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