Syncope Due to Iatrogenic Cava Vein Obstruction: Rare Complication of Cardiac Implantable Electronic Device Leads

Keiko Shimamoto; Kenichiro Yamagata; Hiroki Horinouchi; Kengo Kusano

doi:10.1016/j.jaccas.2024.102347

Syncope Due to Iatrogenic Cava Vein Obstruction: Rare Complication of Cardiac Implantable Electronic Device Leads

JACC Case Rep. 2024 Apr 27;29(11):102347. doi: 10.1016/j.jaccas.2024.102347. eCollection 2024 Jun 5.

Authors

Keiko Shimamoto¹, Kenichiro Yamagata^{1

2}, Hiroki Horinouchi^{1

3}, Kengo Kusano¹

Affiliations

¹ Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
² Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
³ Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan.

Abstract

A 77-year-old female patient with multiple pacemaker leads experienced hypotension and syncope during right heart catheterization. Imaging studies revealed a stenotic inferior vena cava with superior vena cava obstruction and well-developed retrograde collateral vessels, suggesting that balloon obstruction of the sole venous return site caused low cardiac output leading to syncope.

Keywords: calcification; collateral circulation; dialysis; pacemaker; superior vena cava obstruction.