Defibrillator Lead Perforation Leading to Concerning Electrocardiogram Findings: Case Report

Implantable cardioverter-defibrillator (ICD) lead perforation through the myocardium may result in chest pain and electrocardiogram (ECG) changes concerning for ST-segment elevation myocardial infarction. The clinical context of the ECG aids in appropriate management. We report the case of a 71-year...

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Bibliographic Details
Published in:Clinical practice and cases in emergency medicine 2024-05, Vol.8 (2), p.107-110
Main Authors: Rosenberg, Bryan, Hockstein, Max, Hadadi, Cyrus
Format: Article
Language:English
Subjects:
Case Report
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Summary:Implantable cardioverter-defibrillator (ICD) lead perforation through the myocardium may result in chest pain and electrocardiogram (ECG) changes concerning for ST-segment elevation myocardial infarction. The clinical context of the ECG aids in appropriate management. We report the case of a 71-year-old woman experiencing chest pain after an ICD placement two weeks earlier. On presentation, she exhibited ST-segment elevation on her ECG. Computed tomography confirmed ICD lead migration. The patient's hemodynamics were normal, and she was discharged home after a five-day hospital stay following a lead revision. Although rare, ICD lead perforation is a potential cause of chest pain and ischemic ECG changes. Emergency physicians should consider lead perforation as a potential differential diagnosis when evaluating chest pain in patients with ICDs, taking into account the potential complications of coronary angiography.
ISSN:2474-252X
2474-252X
DOI:10.5811/cpcem.1466