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Case Reports
. 2018 Summer;9(3):299-302.
doi: 10.22088/cjim.9.3.299.

Pacemaker lead endocarditis with hiccups (Kalayci)

Belma Kalaycı  1 , Turgut Karabag  1 , Turgay Erten  1 , Tunahan Akgun  1
Affiliations
Case Reports

Pacemaker lead endocarditis with hiccups (Kalayci)

Belma Kalaycı et al. Caspian J Intern Med. 2018 Summer.

Abstract

Background: Lead-related infections that might develop after pacemaker implantation associated with high mortality and morbidity rates are challenging to manage and pose high-cost. Patients with lead-related infections usually present with fever, chills and fatigue and the treatment can be challenging unless the implant system is extracted.

Case presentation: A 66-year old male patient who underwent dual chamber pacemaker and implantable cardioverter defibrillator was admitted to the emergency service with a six-week history of complaints of hiccups and fever. After a detailed investigation, lead-related infective endocarditis was the diagnosis. The patient was initiated on antibiotic therapy and lead extraction was performed.

Conclusions: Patients with signs of infection who underwent pacemaker implantation may present with atypical symptoms such as hiccup. In these cases, imaging, particularly echocardiography, should be performed as soon as possible and the localization of the pacemaker leads and signs of infective endocarditis should be investigated.

Keywords: Echocardiography; Hiccup; Infective endocarditis; Pacemaker lead.

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Figures

Figure 1
Figure 1
Splinter hemorrhages of the patient with infective endocarditis
Figure 2
Figure 2
Implantable cardioverter defibrillator, increased cardiothoracic ratio, bilateral pleural effusions, and dual chamber pacemaker on chest x-ray.
Figure 3
Figure 3
Vegetations floating freely beneath the tricuspid valve (A) and wrapped around the lead and obstructing the tricuspid orifice (B) on apical imaging. (TC; tricuspid, RV; right ventricle)
See this image and copyright information in PMC

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