Presentation
Medical history of non-ischemic cardiomyopathy with an ejection fraction of 30%.
Patient Data
Lines/Tubes/Hardware/Foreign bodies: stable left chest wall AICD and its leads. Enteric tube with a tip projecting beyond the field of this radiograph.
Cardiomediastinal silhouette: the cardiac silhouette is enlarged. Mediastinum is in the midline position.
Lungs: possibly some very minimal predominantly central interstitial prominence with minimal left retrocardiac linear opacities, likely atelectasis.
Pleura: costophrenic angles are sharp bilaterally. No pleural lines are suggestive of pneumothorax.
Visualized bones and soft tissues: no acute displaced fractures.
Case Discussion
An implantable cardioverter-defibrillator, or ICD, is a battery-powered device that continuously monitors heartbeats. It is commonly used to prevent sudden cardiac death in patients at risk of ventricular tachycardia (VT) or ventricular fibrillation. If an irregular beat is suspected, an electrical shock will be delivered via the device to restore a normal rhythm. Candidates for ICDs include those like this patient with heart failure and an ejection fraction <35%, patients with long QT syndrome, Brugada syndrome, cardiac sarcoidosis, or those at risk of myocardial infarction.