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Do not put money where your mouth is!
Natasja M S de Groot1, Arthur J H A Scholte, Monique R M Jongbloed
1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
The American Journal of the Medical Sciences
|December 10, 2009
Summary
A swallowed coin caused temporary heart rhythm changes in a woman by compressing her coronary arteries. The electrocardiogram abnormalities resolved after she vomited the coin, with no underlying heart disease found.
Area of Science:
- Cardiology
- Gastroenterology
- Medical Imaging
Background:
- Foreign body ingestion can present with unusual symptoms.
- Electrocardiogram (ECG) changes can indicate cardiac compromise.
Observation:
- A 60-year-old woman experienced generalized seizure followed by ECG repolarization disorders.
- Symptoms resolved immediately after she vomited a 20-eurocent coin.
Findings:
- Multislice computed tomography revealed no coronary artery disease but an intimate relationship between the esophagus and coronary arteries.
- The coin likely compressed the posterior descending ramus of the right coronary artery and/or the circumflex ramus of the left coronary artery.
Implications:
- Esophageal coin impaction can mimic cardiac events through coronary artery compression.
- This case highlights the importance of considering foreign body ingestion in unexplained ECG abnormalities.
- Anatomical variations in esophageal-coronary artery proximity may predispose to such events.
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