Marine catfish sting causing fatal heart perforation in a fisherman

Many marine catfish have serrated bony stings ("spines"), which are used in defense against predators, on the dorsal and pectoral fins. While catfish-induced injuries are generally characterized by the pain associated with envenomation, the stings in some species are sufficiently long and sharp to cause severe penetrating trauma. Most injuries are to the hands of victims, commonly fishermen. We report the death of a fisherman caused by myocardial perforation from a catfish sting. To our knowledge, this is the first such description in the medical literature.