{"pk":1466,"title":"Defibrillator Lead Perforation Leading to Concerning Electrocardiogram Findings: Case Report","subtitle":null,"abstract":"<b>Introduction: </b>Implantable cardioverter-defibrillator (ICD) lead perforation through the myocardium may result in chest pain and electrocardiogram (ECG) changes concerning for ST-segment elevation myocardial infarction. The clinical context of the ECG aids in appropriate management.<br><p><b>Case Report: </b>We report the case of a 71-year-old woman experiencing chest pain after an ICD placement two weeks earlier. On presentation, she exhibited ST-segment elevation on her ECG. Computed tomography confirmed ICD lead migration. The patient’s hemodynamics were normal, and she was discharged home after a five-day hospital stay following a lead revision.</p><p></p><p><b><b>Conclusion:</b> </b>Although rare, ICD lead perforation is a potential cause of chest pain and ischemic ECG changes. Emergency physicians should consider lead perforation as a potential differential diagnosis when evaluating chest pain in patients with ICDs, taking into account the potential complications of coronary angiography.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"ICD"},{"word":"lead perforation"},{"word":"current of injury"},{"word":"STEMI"},{"word":"ECG"},{"word":"case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8584c4xr","frozenauthors":[{"first_name":"Bryan","middle_name":"","last_name":"Rosenberg","name_suffix":"","institution":"Medstar Washington Hospital Center; Department of Emergency Medicine; Washington, District of Columbia","department":""},{"first_name":"Max","middle_name":"","last_name":"Hockstein","name_suffix":"","institution":"Medstar Washington Hospital Center; Department of Emergency Medicine; Washington, District of Columbia","department":""},{"first_name":"Cyrus","middle_name":"","last_name":"Hadadi","name_suffix":"","institution":"Medstar Washington Hospital Center; Department of Cardiology, Washington, District of Columbia","department":""}],"date_submitted":"2023-06-28T00:05:59.539000Z","date_accepted":"2023-10-02T15:13:28.555000Z","date_published":"2024-03-25T13:00:00Z","render_galley":{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1466/galley/10282/download/"},"galleys":[{"label":"Layout","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1466/galley/3240/download/"},{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1466/galley/10282/download/"}]}