Morrison Margaret L, Karayiannis Steven, Speggiorin Simone, Sands Andrew J, Rosenthal Eric
Department of Paediatric Cardiology, Evelina London Children's Hospital, London, UK.
Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland.
Cardiol Young. 2021 Jan;31(1):159-162. doi: 10.1017/S104795112000342X. Epub 2020 Nov 19.
Cardiac strangulation is a rare and potentially deadly complication of epicardial pacemaker implantation. A young boy presenting with chest pain and tiredness almost 7 years after pacemaker implantation was found to have cardiac strangulation. Literature review revealed 22 cases reported to date with a worrying rise in the number of reports over the past 3 years. Strangulation is associated with implantation of leads at a young age and appears to be related to somatic growth. Serial assessment with chest X-ray and echocardiogram is recommended, at least until full adult growth is attained with further coronary artery imaging reserved for symptoms or suspicious echocardiographic findings. If cardiac strangulation is diagnosed prompt replacement of the offending system is needed.
心脏绞窄是心外膜起搏器植入术一种罕见且可能致命的并发症。一名小男孩在起搏器植入近7年后出现胸痛和疲劳，被发现患有心脏绞窄。文献回顾显示，迄今为止共报告了22例病例，且在过去3年中报告数量呈令人担忧的上升趋势。绞窄与年轻时植入导线有关，似乎与身体生长有关。建议进行胸部X线和超声心动图的系列评估，至少持续到成年完全发育，对于出现症状或超声心动图检查结果可疑的情况，需进一步进行冠状动脉成像。如果诊断为心脏绞窄，需要及时更换有问题的系统。
