Mediastinal haematoma following permanent pacemaker insertion

Mediastinal haematoma post permanent pacemaker insertion (PPI) is a rare complication. We report the case of a woman in her 60s with symptomatic complete heart block, who developed symptoms of respiratory distress following the PPI procedure. Radiological investigations revealed a large mediastinal haematoma. An iatrogenic venous injury must have caused its development. Conservative management led to gradual improvement of symptoms and resolution of haematoma. The patient remained normal on follow-ups. This case underscores the importance of prompt recognition and management of this complication. Mediastinal haematoma following venous injuries has a good prognosis with conservative treatment. Clinicians should be vigilant for this rare complication to ensure timely intervention and favourable outcomes.