An adult with chest pain 24 hours after pacemaker implantation
Subcostal shows a new small peric eff

look the position of the cable, apical modified for rv view

freeze images

CT confirmed

Is this a common finding?, with echo sensit 41%, spec 87% in EUROPACE 2017 (19): 1031-1037.
Diagnosis and management of iatrogenic cardiac perforation caused by pacemaker and defibrillator leads
Best method CT , some difficult with star artifact from the cable

Patients at risk?
Female
Aged patients
Thin
Excessive pressure of the lead or excessive curve
Thin ventricles: DCM, muscular dystrophies
Anticoagulant or steroids in the seven days of implant
Some kind of wires
Apical implant

So: not so common finding with echocardiogram

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