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Spinal Nerves: Plexus I01:22

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Decreased pulse rate01:14

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Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
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Spinal Nerves: Plexus II01:21

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The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Updated: Oct 11, 2025

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Idiopathic brachial plexopathy after pacemaker implant.

Devesh Kumar1, Aayush K Singal1, Raghav Bansal1

  • 1Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.

Pacing and Clinical Electrophysiology : PACE
|December 1, 2021
PubMed
Summary

A rare case of brachial plexopathy occurred after pacemaker implantation. Prompt diagnosis and steroid treatment led to remarkable recovery, avoiding unnecessary surgery.

Keywords:
Idiopathic brachial plexopathybrachial plexus injurycardiac implantable electronic devicepacemaker implant

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Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • Complete heart block necessitates pacemaker implantation for symptom management.
  • Pacemaker implantation, while generally safe, can have rare complications.
  • Brachial plexopathy is a potential, though uncommon, post-procedural neurological complication.

Purpose of the Study:

  • To report a rare case of brachial plexopathy following pacemaker implantation.
  • To emphasize the diagnostic considerations and successful management of this complication.
  • To highlight the importance of recognizing this condition to prevent unnecessary interventions.

Main Methods:

  • Case presentation of a middle-aged woman with complete heart block.
  • Dual chamber pacemaker implantation followed by the onset of left arm symptoms.
  • Neurological examination localizing deficits to the left brachial plexus.
  • Diagnostic workup to rule out mechanical compression by device/leads.
  • Treatment with oral steroids for suspected idiopathic brachial plexopathy.

Main Results:

  • The patient developed left arm pain and weakness three weeks post-pacemaker implantation.
  • Neurological assessment indicated involvement of the lower trunk of the left brachial plexus.
  • Traumatic causes related to the pacemaker device/leads were excluded.
  • The patient showed a remarkable response to oral steroid therapy.
  • Full recovery with minimal neurological deficits was achieved.

Conclusions:

  • Post-pacemaker implantation brachial plexopathy is a rare but important diagnosis to consider.
  • Early recognition and non-surgical management with steroids can lead to excellent outcomes.
  • Distinguishing this condition from mechanical complications is crucial to avoid unwarranted surgical exploration.