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Right ventricular pacing wire thrombus presenting as pyrexia of unknown origin
R A Grunewald1, P L Smith, P Nihoyannopoulos
1Department of Medicine, Royal Postgraduate Medical School, London, England.
Clinical Cardiology
|February 1, 1989
Summary
Pacing wire thrombosis can cause severe symptoms and be difficult to detect. Surgical intervention is recommended over thrombolytic therapy due to the risk of cardiovascular collapse.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Pacing leads are essential for cardiac rhythm management.
- Thrombosis of pacing wires is a rare but serious complication.
Observation:
- A patient presented with a pyrexial illness five months post-pacing wire insertion.
- Echocardiography did not reveal the pacing wire thrombosis.
Findings:
- The patient's pacing wire thrombosis was diagnosed clinically.
- Treatment with tissue plasminogen activator resulted in cardiovascular collapse.
Implications:
- Pacing wire thrombosis requires prompt diagnosis and appropriate management.
- Surgical intervention is the preferred treatment modality for symptomatic pacing wire thrombosis.
- Avoidance of thrombolytic therapy in suspected cases is crucial to prevent adverse events.