Friday, February 17, 2012

Just a Rash

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:

Click image to enlarge
What is this?

-Wes

8 comments:

Anonymous said...

shingles?

DrWes said...

Anony 02:32 -

Nope.

Daniel said...

radiation from leaving the camera in LAO too long trying to put the LV lead in during the failed BiV ....

Mike said...

Daniel's got it I'll bet.

DrWes said...

Daniel -

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.

Daniel said...

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!

ciao!

-danny

Vasi said...

Nice one Dr Wes, love your blog posts!

pinge said...

Has to be radiation