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Foreign bodies in the heart
1Department of Cardiology, Assaf Harofeh Medical Center, Sackler School of Medicine, Tel Aviv University, Zerifin, Israel.
Insights
Foreign bodies in the heart are rare but can cause serious complications. Most migrate to the heart, often presenting years later, requiring surgical or percutaneous removal.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Imaging
Background:
- Foreign bodies in the heart are uncommon but potentially life-threatening, with diverse origins and presentation timelines.
- Diagnostic imaging modalities include X-ray, CT, and echocardiography.
- Management options range from conservative observation to surgical or percutaneous removal.
Observation:
- A total of 104 cases (100 literature, 4 hospital-based) were analyzed.
- The average patient age was 46, with a male predominance (73 men vs. 31 women).
- Common foreign bodies included inferior vena cava filter parts and hydrocephalus shunts.
Findings:
- Foreign bodies were symptomatic in 56% of patients, with the right heart chambers being the most common location.
- Migration was the primary cause (88%), with presentations occurring within 24 hours (20%) or years later (30%).
- Mortality was 3.8% (4 patients); 54% underwent surgical removal, 29% percutaneous removal, and 14% were managed conservatively.
Implications:
- Physicians must recognize the varied presentations of cardiac foreign bodies, which can be fatal.
- Delayed diagnosis and management can lead to severe complications.
- Larger intracardiac foreign bodies are associated with increased complication severity.
Background:
Foreign bodies in the heart are rare, may reach the heart by different ways, and cause serious complications. X-ray, computerized tomography, and echocardiography are main diagnostic modalities. Foreign body can be removed surgically, percutaneously or can be managed conservatively. In this work, we analyzed 100 published cases of a foreign body in the heart and 4 cases that were identified in our hospital.
Methods:
We searched the literature for foreign body in the heart and found 100 published previously cases. Additional 4 cases were identified in our echo laboratory. A total series of 104 patients with a foreign body in the heart were analyzed for the etiology, clinical presentation, symptoms, complications and management.
Results:
Mean patients' age was 46, there were more men than woman 73 versus 31 [P < 0.00005]. The most common foreign bodies were parts of inferior vena cava filters and devices implanted for relieving hydrocephalus. Foreign bodies in the heart were symptomatic in 56% of patients. Right heart chambers were occupied more often. A total of 20% presented within the first 24 hours and 30% of patients presented years after the penetration of the foreign body. A majority of foreign bodies reached the heart by migration [88%]. Mortality was reported in 4 patients [3.8%]. Here 54% of the patients underwent surgical and 29% percutaneous removal of the foreign body, while 14% were followed conservatively.
Conclusion:
Foreign bodies in the heart may present with a wide variety of symptoms. Physicians should be aware of this rare and peculiar complications which may be fatal. Larger devices may result in more severe complications.
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