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A 32-year-old woman was diagnosed at the age of 8 years with a third degree atrioventricular block for which a DDD pacemaker was implanted. She now presented with exertional fatigue and dyspnoea because of a pacemaker lead-induced isolated tricuspid valve stenosis (mean gradient was 4 mm Hg at rest and 19 mm Hg during exercise, measured valve area using planimetry …
Contributors All the above mentioned authors contributed equally to the writing of this Image and approved the manuscript.
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.