Contrasting ultrasound findings in pacemaker lead perforation with and without cardiac tamponade.

Authors

James Chan, Derek Davis, Katrina Shafer, Makayla Scott, Samuel Cory

Published in

BMJ case reports. Volume 19. Issue 8. Aug 20, 2026. Epub Aug 20, 2026.

Abstract

Pacemaker lead perforation is a recognised cause of iatrogenic pericardial effusion and may progress to life-threatening cardiac tamponade. Point-of-care ultrasound (POCUS) is essential for rapid bedside evaluation, yet the distinction between a large but haemodynamically stable effusion and true tamponade physiology requires integration of sonographic findings and clinical presentation. We present two cases of pacemaker-associated haemopericardium with markedly different physiological consequences: one showed haemodynamic instability with clear tamponade and the other initially stable without tamponade despite a massive effusion. This case pair demonstrates how POCUS can be used to differentiate these states and underscores the importance of evaluating both the heart and the patient as a whole.

PMID:
42624630
Bibliographic data and abstract were imported from PubMed on 21 Aug 2026.

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