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Pacemaker placement complicated by intercostal artery injury

Case contributed by Stefan Tigges
Diagnosis certain

Presentation

Pacemaker placement.

Patient Data

Age: 60 years
Gender: Female

Biventricular pacemaker, appropriately positioned, no pneumothorax. Hazy opacity left hemithorax likely due to pleural effusion.

High-density moderate left pleural effusion with extravasation from a left first intercostal artery pseudoaneurysm. Left upper lobe ground-glass opacity, likely pulmonary hemorrhage. Moderate pericardial effusion. Trace left pleural effusion, bilateral dependent atelectasis. Left chest wall emphysema from recent pacemaker placement.  No pneumothorax.

Case Discussion

Nice example of hazy opacity of a hemithorax due to a pleural effusion.

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