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Heart failure in a patient with a pacemaker
  1. José Luis Moya-Mur,
  2. Rocio Hinojar,
  3. José Luis Zamorano
  1. Cardiology Department, Ramón y Cajal University Hospital, Madrid, Spain
  1. Correspondence to Dr Rocio Hinojar, Cardiology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Km 9.100, Madrid 28034, Spain; rociohinojar{at}

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Clinical introduction

A 76-year-old woman was admitted for progressive dyspnoea. Physical examination revealed basal pulmonary crepitations and peripheral oedema. Blood pressure was 135/75 mm Hg and heart rate 60 bpm. B-type natriuretic peptide (BNP) was 600 pg/mL; blood tests were otherwise unremarkable. The ECG showed continuous ventricular pacing and the echocardiogram revealed mild LV hypertrophy with a normal EF. Colour and continuous wave Doppler (CD, CWD) at different phases of the cardiac cycle are presented (figure 1).

Figure 1

2D transthoracic echocardiogram. Upper panel: continuous-wave Doppler recordings of the mitral flow. Lower panels: Colour flow Doppler at different phases of the cardiac cycle (red lines). VC, vena contracta.

Medical history included hypertension and a …

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  • Contributors JLM-M contributed to the acquisition of the images. JLM-M, RH and JLZ contributed to the planning, conduct and reporting of the work. JLZ is responsible for the overall content as guarantor.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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