Needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking ST segment elevation myocardial infarction
Abstract Background Pericardial tamponade is a serious condition which may eventually lead to severe haemodynamic disturbances and cardiac arrest. It is most often caused by the accumulation of fluid inside the pericardium, as a result of different aetiological factors such as pericarditis, neoplast...
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doaj-42896aca25d446a082894a5cc43a76762021-03-21T12:26:15ZengBMCBMC Cardiovascular Disorders1471-22612021-03-012111610.1186/s12872-021-01950-6Needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking ST segment elevation myocardial infarctionMiklós Pólos0Dominika Domokos1Cristina-Maria Şulea2Kálmán Benke3Gergely Csikós4Andrea Nagy5Réka Skoda6András Szabó7Eperke Merkel8István Hartyánszky9Zoltán Szabolcs10Béla Merkely11Dávid Becker12Heart and Vascular Center, Semmelweis UniversityHeart and Vascular Center, Semmelweis UniversityGeorge Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresHeart and Vascular Center, Semmelweis UniversityDepartment of Anesthesiology and Intensive Care, Semmelweis UniversityHeart and Vascular Center, Semmelweis UniversityHeart and Vascular Center, Semmelweis UniversityDepartment of Anesthesiology and Intensive Care, Semmelweis UniversityHeart and Vascular Center, Semmelweis UniversityHeart and Vascular Center, Semmelweis UniversityHeart and Vascular Center, Semmelweis UniversityHeart and Vascular Center, Semmelweis UniversityHeart and Vascular Center, Semmelweis UniversityAbstract Background Pericardial tamponade is a serious condition which may eventually lead to severe haemodynamic disturbances and cardiac arrest. It is most often caused by the accumulation of fluid inside the pericardium, as a result of different aetiological factors such as pericarditis, neoplastic diseases, lymphatic dysfunctions, or idiopathic pericardial disease. Pericardial tamponade can develop after cardiac surgical procedures or as a complication of myocardial infarction. Collection of blood inside the pericardial sack can be the result of pericardial or cardiac trauma. It is exceedingly rare for the injury to be caused by a migrating foreign body. Although a typical picture of pericardial tamponade has been previously described, the disorder may clinically resemble an acute myocardial infarction. Case presentation We report the case of a 58-year-old female patient complaining of new onset thoracic pain and shortness of breath. Electrocardiographic examination results were suggestive of an acute inferior myocardial infarction. However, echocardiography revealed significant pericardial tamponade. The cause was found to be a needle which remained inside the pelvis following a previous cesarean delivery, which the patient had undergone 18 years prior. In emergency setting, the needle was removed and the pericardial tamponade was resolved. Due to the prompt and efficient management, the patient had an uneventful postoperative recovery and presented no recurrence at the follow-up examinations. Conclusions The migration of foreign bodies through tissues is exceedingly rare. If present, it may cause life-threatening complications. Since the aetiology of pericardial tamponade is vast, a thorough assessment is highly important. Therefore, echocardiography is the imaging modality of choice. We wish to highlight the possibility of migrating foreign bodies as probable cause for pericardial tamponade, as well as the importance of echocardiographic methods in the fast-track evaluation of such critical conditions.https://doi.org/10.1186/s12872-021-01950-6Cardiac tamponadeForeign body migrationSTEMICase report |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Miklós Pólos Dominika Domokos Cristina-Maria Şulea Kálmán Benke Gergely Csikós Andrea Nagy Réka Skoda András Szabó Eperke Merkel István Hartyánszky Zoltán Szabolcs Béla Merkely Dávid Becker |
spellingShingle |
Miklós Pólos Dominika Domokos Cristina-Maria Şulea Kálmán Benke Gergely Csikós Andrea Nagy Réka Skoda András Szabó Eperke Merkel István Hartyánszky Zoltán Szabolcs Béla Merkely Dávid Becker Needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking ST segment elevation myocardial infarction BMC Cardiovascular Disorders Cardiac tamponade Foreign body migration STEMI Case report |
author_facet |
Miklós Pólos Dominika Domokos Cristina-Maria Şulea Kálmán Benke Gergely Csikós Andrea Nagy Réka Skoda András Szabó Eperke Merkel István Hartyánszky Zoltán Szabolcs Béla Merkely Dávid Becker |
author_sort |
Miklós Pólos |
title |
Needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking ST segment elevation myocardial infarction |
title_short |
Needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking ST segment elevation myocardial infarction |
title_full |
Needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking ST segment elevation myocardial infarction |
title_fullStr |
Needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking ST segment elevation myocardial infarction |
title_full_unstemmed |
Needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking ST segment elevation myocardial infarction |
title_sort |
needle in the heart: a rare case of cardiac tamponade caused by a migrated foreign body and mimicking st segment elevation myocardial infarction |
publisher |
BMC |
series |
BMC Cardiovascular Disorders |
issn |
1471-2261 |
publishDate |
2021-03-01 |
description |
Abstract Background Pericardial tamponade is a serious condition which may eventually lead to severe haemodynamic disturbances and cardiac arrest. It is most often caused by the accumulation of fluid inside the pericardium, as a result of different aetiological factors such as pericarditis, neoplastic diseases, lymphatic dysfunctions, or idiopathic pericardial disease. Pericardial tamponade can develop after cardiac surgical procedures or as a complication of myocardial infarction. Collection of blood inside the pericardial sack can be the result of pericardial or cardiac trauma. It is exceedingly rare for the injury to be caused by a migrating foreign body. Although a typical picture of pericardial tamponade has been previously described, the disorder may clinically resemble an acute myocardial infarction. Case presentation We report the case of a 58-year-old female patient complaining of new onset thoracic pain and shortness of breath. Electrocardiographic examination results were suggestive of an acute inferior myocardial infarction. However, echocardiography revealed significant pericardial tamponade. The cause was found to be a needle which remained inside the pelvis following a previous cesarean delivery, which the patient had undergone 18 years prior. In emergency setting, the needle was removed and the pericardial tamponade was resolved. Due to the prompt and efficient management, the patient had an uneventful postoperative recovery and presented no recurrence at the follow-up examinations. Conclusions The migration of foreign bodies through tissues is exceedingly rare. If present, it may cause life-threatening complications. Since the aetiology of pericardial tamponade is vast, a thorough assessment is highly important. Therefore, echocardiography is the imaging modality of choice. We wish to highlight the possibility of migrating foreign bodies as probable cause for pericardial tamponade, as well as the importance of echocardiographic methods in the fast-track evaluation of such critical conditions. |
topic |
Cardiac tamponade Foreign body migration STEMI Case report |
url |
https://doi.org/10.1186/s12872-021-01950-6 |
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