Ritin Bomb1, Sunil K Jha2. 1. Cardiologist at the University of Tennessee Health Science Center College of Medicine in Memphis. ritinbomb@gmail.com. 2. Assistant Professor of Cardiovascular Diseases at the University of Tennessee Health Science Center in Memphis. sjha1@uthsc.edu.
Abstract
INTRODUCTION: A bilateral large spontaneous pneumothorax to our knowledge has never been reported after a device implantation. We report an unusual case of a patient developing spontaneous bilateral large pneumothoraxes after an implantable cardioverter-defibrillator generator and lead revision without evidence of any obvious traumatic cardiac injury. CASE PRESENTATION: A 79-year-old white man was scheduled for implantable cardioverter-defibrillator generator change and addition of an atrial lead. Approximately one hour after the procedure, he suddenly went into respiratory distress with profuse sweating, and pallor with falling oxygen saturation and blood pressure. Chest x-ray showed bilateral large pneumothoraxes. DISCUSSION: In our literature search, we found no reports of large bilateral pneumothorax in the absence of any traumatic cardiac or lung injury. Rupture of bilateral pleura during subclavian access or presence of pleuropleural communication or a right atrial microperforation could be possible causes.
INTRODUCTION: A bilateral large spontaneous pneumothorax to our knowledge has never been reported after a device implantation. We report an unusual case of a patient developing spontaneous bilateral large pneumothoraxes after an implantable cardioverter-defibrillator generator and lead revision without evidence of any obvious traumatic cardiac injury. CASE PRESENTATION: A 79-year-old white man was scheduled for implantable cardioverter-defibrillator generator change and addition of an atrial lead. Approximately one hour after the procedure, he suddenly went into respiratory distress with profuse sweating, and pallor with falling oxygen saturation and blood pressure. Chest x-ray showed bilateral large pneumothoraxes. DISCUSSION: In our literature search, we found no reports of large bilateral pneumothorax in the absence of any traumatic cardiac or lung injury. Rupture of bilateral pleura during subclavian access or presence of pleuropleural communication or a right atrial microperforation could be possible causes.
Authors: Małgorzata Hardzina; Andrzej Ząbek; Krzysztof Boczar; Paweł Matusik; Barbara Małecka; Jacek Lelakowski Journal: Postepy Kardiol Interwencyjnej Date: 2015-01-12 Impact factor: 1.426