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Large right atrial pacemaker lead thrombus diagnosed by chest CT angiography
  1. Kuei-Feng Lin1,
  2. Fu-Zong Wu1,2,3
  1. 1Department of Radiology, Section of Thoracic and Circulation Imaging, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
  2. 2Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan
  3. 3Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan
  1. Correspondence to Dr Fu-Zong Wu, Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, 81346, Taiwan or Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan; cmvwu{at}hotmail.com or cmvwu1029{at}gmail.com

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A 74-year-old woman presented with chest tightness and progressive dyspnoea for 1 week. She had past history of cardiac surgery for tricuspid annuloplasty and mitral valve replacement 2 years previously. A ventricular rate responsive pacemaker was implanted for atrial fibrillation 3 months previously. Physical examination revealed a grade 3/6 holosystolic murmur at the left heart apex. Lab examination showed elevation of D-dimer level. Chest radiograph showed severe cardiomegaly (figure 1). Chest CT angiography was performed for suspected pulmonary embolism. Chest CT showed a …

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