Upper back, collarbone pain 6 mo after pacemaker

Hello - 32 yo. 7 mo post op. I've been having back pain and pain under the collarbone for the last 3 days. I'd started out on my pacemaker side as a nerve ish type pain, but now it's extending over my whole back to where I can't get comfortable when I sleep and need Tylenol.

I'm in the hospital now because I had similar pain a week after my surgery. They sent me

home from the ER with a dx of pleurisy, but 2 days later I was back in the ER by ambulance due to cardiac tampenade. I came in this time

becagse I was worried it's happening again.

This time, Echo and chest X-ray look good. It seems like no one is overly concerned but I'm worried im not conveying my symptoms effectively. Has this happened to anyone else?


Collarbone pain, upper back pain and chest pain

by Gemita - 2020-06-10 13:36:05

Hello GUODS2020.

I can relate to what you are going through and I am sure you have conveyed your symptoms effectively to your doctors.  In view of your past experience with Cardiac Tamponade you absolutely did the right thing to present yourself to ER since any chest pain symptoms (collarbone area) should be investigated.  I see the Echo and X-ray both looked normal but that is not to say that there is nothing going on, only that these imaging techniques have not detected a problem.

I would politely ask whether some more sensitive imaging should be carried out, like a thoracic CT scan with contrast or an MRI or other appropriate tests ?  

I also have ongoing intermittent collarbone pain radiating to my upper back, but I do have osteoporosis.  I am though known to have some compression of my subclavian vein which occurred during pacemaker lead implant which is probably causing some of my symptoms but my doctors are not too concerned at the moment because there is no associated arm swelling to suggest total occlusion of the vein.  I have developed a good network of colateral veins around the pacemaker site to compensate for any blockage/narrowing and I am taking anticoagulants for Atrial Fibrillation in any event to protect me from developing blood clots.  I will be making noises though for further tests if my pain symptoms worsen and so should you. 

There are just so many potential causes for your continuing pain and quite often these settle (eventually) without any intervention which is what your doctors are probably hoping for.  You have clearly been traumatised from your previous surgery and it may take time for you to completely recover.  However you are perfectly entitled to get some answers as to the likely cause of your pain for your own peace of mind and in order to receive effective pain management and this is what I would strongly convey to your doctors. 

Good luck



Follow up

by guods2020 - 2020-06-20 10:04:46

I saw a new cardiologist and he thinks it's Dressler's syndrome. I have a baseline CT next week to make sure I don't have inflammation of my pericardium.


i am 100% better now (until the next flare up)

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