Pacemaker syndrome differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

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Differentiating Pacemaker syndrome from other Diseases

Patients with pacemaker syndrome present with varied symptoms resulting from dyssynchrony between atria and ventricles.

Presenting symptoms include:

Dyspnea
Edema
Orthopnea
Symptoms of low cardiac output like weakness, fatigue, lightheadedness and dyspnea on exertion
Hypotension
Shock
Orthostatic changes
Syncope
Dizziness
Right upper quadrant pain
Headaches
Palpitations
Easy fatigability

Pacemaker syndrome should be differentiated from the following diseases:

If patient had implanted ventricular pacemaker and develops new neurological or cardiovascular symptoms, consider Pacemaker Syndrome as a differential diagnosis.
Acute coronary syndrome
Failed pacemaker
Hypothyroidism
Cardiogenic pulmonary edema
Arrhythmias (especially supraventricular tachycardias)
Hyperthyroidism
Pulmonary embolism
Carotid sinus hypersensitivity