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Cardiac strangulation after epicardial pacing: the importance of non-specific symptoms and a low index of suspicion

Published online by Cambridge University Press:  19 November 2020

Margaret L. Morrison ,
Steven Karayiannis ,
Simone Speggiorin ,
Andrew J. Sands  and
Eric Rosenthal Open the ORCID record for Eric Rosenthal [Opens in a new window]
Margaret L. Morrison*
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, London, UK
Steven Karayiannis
Affiliation:
Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
Simone Speggiorin
Affiliation:
Department of Cardiothoracic Surgery, Evelina London Children’s Hospital, London, UK
Andrew J. Sands
Affiliation:
Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
Eric Rosenthal
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, London, UK
*
Author for correspondence: Dr Margaret L. Morrison, Department of Paediatric Cardiology, Evelina London Children’s Hospital, London, UK. Tel: +44 020 7188 7188. E-mail: louisemorrison@doctors.org.uk
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Abstract

Cardiac strangulation is a rare and potentially deadly complication of epicardial pacemaker implantation. A young boy presenting with chest pain and tiredness almost 7 years after pacemaker implantation was found to have cardiac strangulation. Literature review revealed 22 cases reported to date with a worrying rise in the number of reports over the past 3 years. Strangulation is associated with implantation of leads at a young age and appears to be related to somatic growth. Serial assessment with chest X-ray and echocardiogram is recommended, at least until full adult growth is attained with further coronary artery imaging reserved for symptoms or suspicious echocardiographic findings. If cardiac strangulation is diagnosed prompt replacement of the offending system is needed.

Keywords

Pacingcomplicationscardiac strangulation
Type
Brief Report
Information
Cardiology in the Young , Volume 31 , Issue 1 , January 2021 , pp. 159 - 162
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

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