Paediatric pacemaker

Case contributed by Dr Jeremy Jones

Presentation

Acute and profound cardiac decompensation. Pacemaker and mitral valve replacement several months previously. Septic.

Patient Data

Age: 6 months
Gender: Male
X-ray

ETT and NGT appropriately sited.  V-A ECMO.  MVR.  Pacemaker.

Cardiomegaly with left-sided air-space opacification consistent with infection or pulmonary oedema (the latter being less likely given the unilaterality).  Small left sided effusion.

Annotated image

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.

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Case information

rID: 24112
Case created: 28th Jul 2013
Last edited: 27th Feb 2016
Inclusion in quiz mode: Excluded

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