August 1969, Vol 124, No. 2 >

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ARTICLE | August 1969

Systolic Murmurs Induced by Pacemaker Catheters

Gurbux H. Nachnani, MD; Alden S. Gooch, MD; Irene Hsu, MD

Arch Intern Med. 1969;124(2):202-205. doi:10.1001/archinte.1969.00300180074014.

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ABSTRACT

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Systolic murmurs of diverse etiologies may appear in association with acute myocardial infarction.^1,2 Some are transient and of little consequence while others are manifestations of significant complications. Recently we encountered three patients with transient systolic murmurs which appeared after the introduction of a temporary transvenous pacemaker catheter into the right ventricle. Two of these patients had acute myocardial infarction complicated by arrhythmias and one had Adams-Stokes attacks. The clinical characteristics of such iatrogenic murmurs and their differential diagnosis form the basis of this presentation.

Patient Summaries

Patient 1. —A 47-year-old white woman was admitted to the George Washington University Hospital with an acute anterior myocardial infarction, complicated by complete heart block with several Adams-Stokes episodes. There were no murmurs. A bipolar electrode catheter was postioned in the right ventricle and functioned well, on a demand basis. Several hours later, a scratchy, squeaky, high-pitched grade 2/6 late systolic murmur

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Nachnani GH, Gooch AS, Hsu I. Systolic Murmurs Induced by Pacemaker Catheters. Arch Intern Med. 1969;124(2):202-205. doi:10.1001/archinte.1969.00300180074014.

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