Key result
Recurrent postcardiac injury syndrome following pacemaker lead insertion can mimic cardiac perforation, presenting with hemorrhagic pleuro-pericardial effusion and a drop in hemoglobin.
Case Report (n=1)
Postcardiac injury syndrome should be considered in the differential diagnosis for patients developing pericardial and pleural effusion with inflammatory markers after pacemaker lead insertion, as it can mimic cardiac perforation.
May warrant considering postcardiac injury syndrome in post-pacemaker effusions; hypothesis-generating case leaves open prospective incidence studies.
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.
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Krishnan et al. (2006) conducted a case report in Recurrent postcardiac injury syndrome (PCIS) (n=1). Pacemaker lead insertion was evaluated. Recurrent postcardiac injury syndrome following pacemaker lead insertion can mimic cardiac perforation, presenting with hemorrhagic pleuro-pericardial effusion and a drop in hemoglobin.
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