Foreign body mimicking acute coronary syndrome

Area of Science:

• Cardiology
• Toxicology
• Radiology

Background:

• Intravenous drug use carries risks of systemic complications.
• Foreign body embolism to the heart is a rare but serious event.
• Acute coronary syndrome is a common presentation in cardiology units.

Observation:

• A 37-year-old male presented with suspected acute coronary syndrome.
• Imaging revealed a broken needle in the pericardium, originating from intravenous heroin administration.
• Computed tomography confirmed the needle's path from the right femoral vein to the heart.

Findings:

• Acute coronary syndrome was ruled out.
• A foreign body (broken needle) was identified within the pericardium.
• The needle's migration pathway was traced to intravenous drug use.
• Developing pericardial tamponade was diagnosed.

Implications:

• This case highlights the critical importance of thorough patient history and diagnostic imaging in cases of suspected cardiac events.
• It underscores the severe cardiovascular complications associated with intravenous drug abuse.
• Prompt surgical intervention is crucial for managing foreign body-induced pericardial tamponade.