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Related Concept Videos

Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

207
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
207
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

182
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
182
Pericarditis I: Introduction01:22

Pericarditis I: Introduction

48
Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
48
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

73
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
73
Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

104
Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
104
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

62
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
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Pacemaker lead related myocardial perforation.

Prianka Kumar1, Joseph Skrabal1, Sarah E Frasure1

  • 1Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States.

The American Journal of Emergency Medicine
|September 13, 2021
PubMed
Summary
This summary is machine-generated.

Permanent pacemaker (PPM) insertion complications can be serious. Right ventricular lead perforation causing pericardial effusion is a rare but life-threatening event to consider in patients with recent PPM.

Keywords:
DyspneaLead perforationPacemakerPericardial effusion

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Area of Science:

  • Cardiology
  • Medical Devices
  • Patient Safety

Background:

  • Permanent pacemaker (PPM) insertion treats cardiac rhythm disorders, with ~600,000 US annual implants.
  • About 9% of patients experience complications, including lead issues, infections, and programming problems.
  • Severe lead-related issues occur in 1-2% within 30 days of PPM insertion.

Observation:

  • This report details a rare but serious PPM complication: right ventricular lead perforation.
  • The perforation led to a significant pericardial effusion, a potentially life-threatening condition.
  • Patients may present to the emergency department with chest pain, dyspnea, or syncope after PPM insertion.

Findings:

  • Lead perforation, though uncommon, requires consideration in the differential diagnosis for patients with recent PPM and relevant symptoms.
  • Diagnostic evaluation typically includes chest radiography and ECG to assess lead placement and function.
  • The case highlights a patient diagnosed with lead perforation and pericardial effusion three days post-PPM insertion.

Implications:

  • Prompt recognition of lead perforation and associated pericardial effusion is crucial for timely intervention.
  • Considering lead perforation in patients with recent PPM and concerning symptoms can prevent delayed diagnosis and treatment.
  • Understanding rare complications improves patient safety and management strategies for pacemaker recipients.