Presentation
Pacemaker placement 1 month earlier for recurrent syncope. The patient presented to the emergency department with three episodes of syncope with sinus tachycardia. Pulmonary embolism was suspected.
Patient Data
The dual chamber cardiac pacers leads should terminate in the right atrial appendage and right ventricular apex. In this case, the distal end of an electrode is identified in the RA appendage, and the other wire crosses the myocardial wall of the VD apex and ends in the pericardial space (myocardial rupture).
It associates moderate pericardial effusion and a slight amount of liquid on the anterior mediastinum (suggestive findings of pericardial rupture).
Case Discussion
Myocardial perforation is one of the main complications of pacemaker placement.
The ventricular wire was removed and another wire inserted.
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