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Budd-Chiari syndrome due to pacemaker-induced thrombosis
Journal of Gastroenterology and Hepatology
|May 1, 1995
Summary
Pacemaker leads can cause Budd-Chiari syndrome through thrombosis. Removing the pacemaker and performing thrombectomy resolved symptoms in a unique case, supporting the thrombosis theory for IVC obstruction.
Area of Science:
- Cardiology
- Vascular Surgery
- Gastroenterology
Background:
- Pacemaker implantation is common for cardiac arrhythmias like paroxysmal supraventricular tachycardia.
- Wolff-Parkinson-White syndrome can necessitate permanent pacemaker insertion.
- Complications of pacemakers can include lead dislodgement and infection.
Observation:
- A patient with Wolff-Parkinson-White syndrome developed Budd-Chiari syndrome 5 years after pacemaker re-implantation.
- Symptoms included abdominal pain, ascites, hepatomegaly, and dilated inferior vena cava.
- Imaging revealed extensive thrombus formation in the superior vena cava, right atrium, and inferior vena cava.
Findings:
- Budd-Chiari syndrome was attributed to pacemaker leads-induced thrombosis.
- Surgical intervention involved pacemaker removal and thrombectomy.
- Complete resolution of clinical symptoms was achieved post-operatively.
Implications:
- This case highlights a rare complication of pacemaker therapy.
- It underscores the potential for lead-induced thrombosis to cause major venous obstruction.
- The findings support the thrombosis theory in the pathogenesis of inferior vena cava membranous obstruction.