by Amir Gahremanpour, MD, Mohammad Saeed, MD, and Yochai
Birnbaum, MD
A 65-year-old woman with a history of congestive heart
failure presented at the emergency department with right-sided upper-chest and
shoulder discomfort. Two months prior, she had been given a single-lead Fortify
Assura™ VR 1357-40Q implantable cardioverter-defibrillator (ICD) (St. Jude
Medical, now part of Abbott Laboratories; St. Paul, Minn). She described her
symptoms, which had started 6 hours before admission, as off-and-on pain of
mild-to-moderate severity that was not associated with exertion or respiration.
She reported no shortness of breath, cough, fever, chills, or dizziness. An
electrocardiogram (ECG) was obtained upon presentation (Fig. 1).
