Fatigue and Syncope Caused by Right Ventricular Perforation by a Pacemaker Lead.

Cardiac devices with intra-ventricular leads are associated with a risk of perforation. This can be a diagnostic challenge given that there is a whole spectrum of clinical presentation from incidental discovery on imaging to large effusions and tamponade. Here we present a case where a patient with permanent pacemaker for complete heart block presented with worsening fatigue that deteriorated to syncopal episodes.

Exploring the impact of the COVID-19 pandemic on provision of cardiology services: a scoping review.

The coronavirus disease-19 (COVID-19) pandemic has forced hospitals to prioritize COVID-19 patients, restrict resources, and cancel all non-urgent elective cardiac procedures. Clinical visits have only been facilitated for emergency purposes. Fewer patients have been admitted to the hospital for both ST-segment elevation myocardial infarctions (STEMI) and non-ST segment elevation myocardial infarctions (NSTEMI) and a profound decrease in heart failure services has been reported.