An Unusual Cause of Localised ST Elevation following Insertion of a Permanent Pacemaker

Localised ST elevation, chest pain and dyspnoea usually indicate ST elevation myocardial infarction. This 81-year-old female presented with worsening chest pain and dyspnoea four days post-insertion of a dual chambered pacemaker for sick sinus syndrome on Apixaban thromboprophylaxis for atrial fibrillation. Her background included unrepaired atrial septal defect, moderate to severe right ventricular (RV) dilatation and pulmonary hypertension. Her systolic blood pressure was 120mmHg and heart-rate 80bpm, JVP was elevated at 9cm.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Image Source Type: research