Presentation
Acute and profound cardiac decompensation. Pacemaker and mitral valve replacement several months previously. Septic.
Patient Data
Age: 6 months
Gender: Male
From the case:
Pediatric pacemaker
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/24360/annotated_viewer_json?iframe=true\u0026lang=us"}
ETT and NGT appropriately sited. V-A ECMO. MVR. Pacemaker.
Cardiomegaly with left-sided air-space opacification consistent with infection or pulmonary edema (the latter being less likely given the unilaterality). Small left sided effusion.
From the case:
Pediatric pacemaker
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/24361/annotated_viewer_json?iframe=true\u0026lang=us"}
Normal appearance of the pacemaker with no fracture around the pin insertion point.
Case Discussion
When assessing a pacemaker, look at lead position, but also look at the termination points where the leads are inserted. If there is a fracture of the lead or it has migrated out of the termination point, the pacemaker will not work.