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Delayed cardiac tamponade after pacemaker insertion.

T Gershon1, J Kuruppu, J Olshaker

  • 1Emergency Care Services, Veterans Affairs Medical Center, Baltimore, MD 21201, USA.

The Journal of Emergency Medicine
|March 24, 2000
PubMed
Summary
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Cardiogenic shock can rarely result from cardiac tamponade, a serious complication following permanent pacemaker insertion. This case highlights the importance of considering pacemaker complications in patients presenting with shock.

Area of Science:

  • Cardiology
  • Emergency Medicine

Background:

  • Cardiogenic shock is a critical condition requiring prompt management.
  • Common causes include myocardial infarction, aortic dissection, pulmonary embolism, and cardiac tamponade.

Observation:

  • A patient presented with cardiogenic shock 10 days post-permanent cardiac pacemaker insertion.
  • The patient developed pericardial tamponade, a rare complication attributed to the pacemaker procedure.

Findings:

  • While right ventricular perforation during pacemaker insertion is usually benign, this case demonstrates it can lead to severe tamponade and hemodynamic compromise.
  • Cardiac tamponade as a consequence of pacemaker insertion is infrequently reported in medical literature.

Implications:

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  • This case underscores the need for heightened awareness of cardiac tamponade as a potential complication of permanent pacemaker implantation.
  • Clinicians should consider pacemaker-induced cardiac tamponade in the differential diagnosis of cardiogenic shock, especially in patients with recent pacemaker procedures.