He was referred for consideration of a biventricular ICD implant after a failed attempt at an outside institution. When listening to his lungs posteriorly, a 'little' rash was noted:
Yes, this is a radiation burn. The patient had a 7-hour attempt at placement of the LV lead and developed this radiation burn as a result.
Unless noticed, this rash often goes unappreciated for its etiology. Since the radiation source in cath and EP labs sits beneath the patient table, radiation burns from prolonged exposure to fluoroscopy usually occur on the patient's back.
In this case, the camera must have spent a long time on in the LAO position. This rash was seen approx 3 weeks after the initial procedure. Fortunately for this patient, a month later it was no longer visible.
your clinic seems to be the place TO BE on friday afternoons between persistent left sided SVCs and radiation burns...keep it all comin', love the blog!
shingles?
ReplyDeleteAnony 02:32 -
ReplyDeleteNope.
radiation from leaving the camera in LAO too long trying to put the LV lead in during the failed BiV ....
ReplyDeleteDaniel's got it I'll bet.
ReplyDeleteDaniel -
ReplyDeleteYes, this is a radiation burn. The patient had a 7-hour attempt at placement of the LV lead and developed this radiation burn as a result.
Unless noticed, this rash often goes unappreciated for its etiology. Since the radiation source in cath and EP labs sits beneath the patient table, radiation burns from prolonged exposure to fluoroscopy usually occur on the patient's back.
In this case, the camera must have spent a long time on in the LAO position. This rash was seen approx 3 weeks after the initial procedure. Fortunately for this patient, a month later it was no longer visible.
your clinic seems to be the place TO BE on friday afternoons between persistent left sided SVCs and radiation burns...keep it all comin', love the blog!
ReplyDeleteciao!
-danny
Nice one Dr Wes, love your blog posts!
ReplyDeleteHas to be radiation
ReplyDelete