case_images: PMC5364770_01
case_images: Postprocedure chest X-ray demonstrated proper positions of both right atrial and ventricular leads. No evidence of pleural effusions or pneumothorax were seen
case_images: IJCIIS-7-65-g001.jpg
case_images: PMC5364770_01_IJCIIS-7-65-g001.jpg
case_images: F1
case_images: A routine chest X-ray confirmed acceptable right atrial and RV lead placement with no initial complications [Figure 1].
case_images: Bruising was clearly seen later and inferior to her left breast
case_images: IJCIIS-7-65-g002.jpg
case_images: PMC5364770_01_IJCIIS-7-65-g002.jpg
case_images: F2
case_images: Atypical tenderness to palpation and bruising were also noted in the left mid-axillary region [Figure 2].
case_images: Follow-up chest X-ray suggesting erosion of right ventricular lead into the pleural space and into the chest wall. Anatomically, this corresponded to the cutaneous bruising
case_images: IJCIIS-7-65-g003.jpg
case_images: PMC5364770_01_IJCIIS-7-65-g003.jpg
case_images: F3
case_images: No obvious widening of the cardiac silhouette or pleural effusion was appreciated [Figure 3].
case_images: Computed tomography scan of the chest confirmed erosion of the lead through the pericardium and embedding into the intercostal/rib space. Interestingly, no pleural or pericardial effusions, hemothorax, or pneumothorax were seen radiographically
case_images: IJCIIS-7-65-g004.jpg
case_images: PMC5364770_01_IJCIIS-7-65-g004.jpg
case_images: F4
case_images: A computed tomography (CT) scan confirmed cardiac perforation with lead erosion into the 6th rib [Figure 4].
case_images: PMC5364770_02