Placement of a pacemaker lead most commonly contributes to which valvular lesion?

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Prepare for the Rosh Internal Medicine Exam with quizzes, flashcards, and multiple-choice questions, complete with hints and explanations. Get ready to excel on your exam!

Multiple Choice

Placement of a pacemaker lead most commonly contributes to which valvular lesion?

Explanation:
The key idea is that transvenous pacemaker leads traverse the tricuspid valve to reach the right ventricle, and their presence can disrupt valve closure. The lead can impinge on the tricuspid leaflets or tether them, leading to ineffective coaptation and resulting in tricuspid regurgitation. This makes tricuspid regurgitation the most common valvular lesion associated with pacemaker leads. The other valves aren’t typically crossed by the lead in standard placement, so they’re less likely to be directly affected by the device.

The key idea is that transvenous pacemaker leads traverse the tricuspid valve to reach the right ventricle, and their presence can disrupt valve closure. The lead can impinge on the tricuspid leaflets or tether them, leading to ineffective coaptation and resulting in tricuspid regurgitation. This makes tricuspid regurgitation the most common valvular lesion associated with pacemaker leads. The other valves aren’t typically crossed by the lead in standard placement, so they’re less likely to be directly affected by the device.

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