Preschooler with an arrhythmia

CXR of broken cardiac pacemaker leads
CXR AP (left) shows short lucent areas in the lateral aspect of the third and fourth pacemaker leads. Repeat CXR AP 1 month later (right) shows a complete discontinuity of the third pacemaker lead and elongation of the lucent area in the lateral aspect of the fourth pacemaker lead.

The diagnosis was cardiac pacemaker lead malfunction in the form of developing fractures in the pacemaker leads.