Pneumothorax leading to pneumopericardium after transvenous lead implantation in a patient with previous epicardial lead.

A 44-year-old lady, a follow up case of idiopathic dilated cardiomyopathy and cardiac resynchronization therapy defibrillator (CRT-D) device implantation with epicardial left ventricular (LV) lead, underwent a transvenous LV lead revision in view of epicardial lead malfunction. A chest X-ray after this, done for worsening dyspnoea, revealed pneumopericardium along with left pneumothorax. The CT revealed a communication between the left pleural and pericardial cavities, around the old epicardial lead. Drainage of the left pleural cavity resolved both the pneumothorax and pneumopericardium and the patient remained well on follow up. This article is protected by copyright. All rights reserved.