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Needle Embolism to the Heart: A Case Report and Review
Scott Hatcherson1, Vikramaditya S Venkata2, Surya Aedma3
1Graduate Medical Education, Methodist Health System, Dallas, USA.
Cureus
|May 17, 2021
Summary
Rare heart needle embolisms require careful management. This case highlights the need for multidisciplinary decision-making regarding needle removal, considering patient stability and migration risks.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Case Reports
Background:
- Needle embolisms in the heart are exceptionally rare clinical events.
- Management strategies are predominantly guided by accumulated clinical experience rather than established protocols.
Observation:
- A patient presented with chest pain and dyspnea, exhibiting subtle inferolateral ST segment elevations on electrocardiogram.
- Diagnostic imaging revealed a pericardial effusion containing a needle, leading to cardiac tamponade.
Findings:
- The needle, likely from a past injection, was the source of the bloody pericardial effusion and tamponade.
- The decision for surgical or interventional needle removal is complex and necessitates a multidisciplinary approach to mitigate procedural risks.
Implications:
- This case underscores the importance of a comprehensive, team-based strategy for managing cardiac foreign bodies.
- Conservative management may be appropriate for stable, non-migrating intracardiac needles, avoiding unnecessary surgical intervention.
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