A Case of Idiopathic Chest Pain Following Watchman Device Placement

Chest pain following left atrial appendage closure (LAAC) with the Watchman device is rare but can occur due to complications such as pericarditis or myocardial infarction. We present the case of a 59-year-old male with atrial fibrillation who developed sharp, left-sided chest pain exacerbated by inspiration after undergoing Watchman device placement. Despite extensive diagnostic evaluations, including electrocardiograms (ECGs), echocardiograms, and cardiac catheterization, the exact cause of the pain remained unclear, with no signs of acute coronary syndrome or pericardial effusion. The patient's symptoms persisted despite treatment with colchicine and anti-inflammatory agents including steroids. Due to the severe and persistent nature of the pain, the patient opted for surgical removal of the Watchman device. This procedure led to a significant resolution of his symptoms. This case underscores the need to consider device removal for persistent, idiopathic chest pain after LAA occlusion, especially when other causes are excluded and conservative management fails.