Case
61 year-old male having CABG and VVI-ICD implanted after MI was admitted with dyspnea. Echocardiography and tomography showed pericardial tamponade (figure d). EF was 35 %. 1150 ml. serous pericardial effusion was drained. The patient was readmitted with dyspnea 45 days later. Pericardial tamponade was seen with echocardiography (figure e-f) and effusion was drained. Electrocardiography showed pacemaker rhythm with atrial activity consistant with retrograde p waves (figure a ). Pacemaker lower rate was reduced to 40 and sinus ritm at 44/minutes appeared. He was readmitted 20 months later. Echocardiography showed pericardial effusion and tamponade( fig g). ECG showed ventricular pacemaker rhythm at the rate of 45 (figure b ). Pericardial effusion was drained (figure h). Pacemaker lower rate was reduced to 30 beats/minute and a sinus rate with a rate of 37 beats/minute appeared (figure b ). Patients was thought to have pacemaker syndrome due to retrograde ventriculoatrial conduction. EPS showed retrograde conduction over Atrioventricular node. Amiodarone was causing bradycardia and stopped. After 4 mounths, rhythm was sinus, no pericardial effusion was present (figure c-i).
Case
61 year-old male having CABG and VVI-ICD implanted after MI was admitted with dyspnea. Echocardiography and tomography showed pericardial tamponade (figure d). EF was 35 %. 1150 ml. serous pericardial effusion was drained. The patient was readmitted with dyspnea 45 days later. Pericardial tamponade was seen with echocardiography (figure e-f) and effusion was drained. Electrocardiography showed pacemaker rhythm with atrial activity consistant with retrograde p waves (figure a ). Pacemaker lower rate was reduced to 40 and sinus ritm at 44/minutes appeared. He was readmitted 20 months later. Echocardiography showed pericardial effusion and tamponade( fig g). ECG showed ventricular pacemaker rhythm at the rate of 45 (figure b ). Pericardial effusion was drained (figure h). Pacemaker lower rate was reduced to 30 beats/minute and a sinus rate with a rate of 37 beats/minute appeared (figure b ). Patients was thought to have pacemaker syndrome due to retrograde ventriculoatrial conduction. EPS showed retrograde conduction over Atrioventricular node. Amiodarone was causing bradycardia and stopped. After 4 mounths, rhythm was sinus, no pericardial effusion was present (figure c-i).
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