Be aware of wires in the veins: a case of superior vena cava syndrome in a patient with permanent pacemaker

Agegnehu T Gebreyes, Hom Nath Pant, Donna M Williams, Sapna P Kuehl
Journal of Community Hospital Internal Medicine Perspectives 2012, 2 (3)
Superior vena cava (SVC) syndrome is an unusual complication of pacemaker and implantable cardioverter-defibrillator implantation. It is believed to be due to SVC thrombosis with or without stenosis induced by endothelial disruption from repeated mechanical trauma by the leads. A 58-year-old man presented with gradual swelling of his face, neck, and upper extremities of 10 days duration. A pacemaker had been implanted for symptomatic bradycardia over 5 years ago. Venous Doppler and venogram revealed thrombosis and stenosis of the SVC. He was treated with multimodal therapy and was discharged with complete resolution of his symptoms.

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