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Constrictive pericarditis complicating an endocardial pacemaker.

A 62-year-old man was admitted with a three week history of episodic dizziness and effort dyspnoea. He had had mild hypertension for one year, but there was no history of any other cardiovascular disease. On physical examination he had a heart rate of 35/ minute, blood pressure of 235/90 mmHg, and a normal jugular venous pressure. The apex beat was mildly thrusting. On auscultation the heart sounds were normal and there was a grade 1/4 ejection systolic murmur in the aortic area. The electrocardiogram showed 2:1 atrioventricular block and left anterior hemiblock with a ventricular