Abstract
BackgroundPericardial tamponade is a serious condition which may eventually lead to severe haemodynamic disturbances and cardiac arrest. It is most often caused by the accumulation of fluid inside the pericardium, as a result of different aetiological factors such as pericarditis, neoplastic diseases, lymphatic dysfunctions, or idiopathic pericardial disease. Pericardial tamponade can develop after cardiac surgical procedures or as a complication of myocardial infarction. Collection of blood inside the pericardial sack can be the result of pericardial or cardiac trauma. It is exceedingly rare for the injury to be caused by a migrating foreign body. Although a typical picture of pericardial tamponade has been previously described, the disorder may clinically resemble an acute myocardial infarction.Case presentationWe report the case of a 58-year-old female patient complaining of new onset thoracic pain and shortness of breath. Electrocardiographic examination results were suggestive of an acute inferior myocardial infarction. However, echocardiography revealed significant pericardial tamponade. The cause was found to be a needle which remained inside the pelvis following a previous cesarean delivery, which the patient had undergone 18 years prior. In emergency setting, the needle was removed and the pericardial tamponade was resolved. Due to the prompt and efficient management, the patient had an uneventful postoperative recovery and presented no recurrence at the follow-up examinations.ConclusionsThe migration of foreign bodies through tissues is exceedingly rare. If present, it may cause life-threatening complications. Since the aetiology of pericardial tamponade is vast, a thorough assessment is highly important. Therefore, echocardiography is the imaging modality of choice. We wish to highlight the possibility of migrating foreign bodies as probable cause for pericardial tamponade, as well as the importance of echocardiographic methods in the fast-track evaluation of such critical conditions.
Highlights
Pericardial tamponade is a serious condition which may eventually lead to severe haemodynamic disturbances and cardiac arrest
We wish to highlight the possibility of migrating foreign bodies as probable cause for pericardial tamponade, as well as the importance of echocardiographic methods in the fast-track evaluation of such critical conditions
Pericardial tamponade (PT) may develop after interventional cardiological procedures or open heart surgery, or as a complication of myocardial infarction [2]
Summary
Migrating foreign bodies are a rarely occurring situation. An exact mechanism for this phenomenon has not yet been defined. To the best of our knowledge, this is the firstly reported case of cardiac injury caused by a wandering foreign body, namely a remaining needle following cesarean delivery, and causing pericardial tamponade which mimicked ST segment elevation myocardial infarction. It presents a rare example of long-distance chronic migration of a foreign body. By describing this case, we wish to highlight the possibility to encounter common pathologies with uncommon aetiologies in the regular medical practice, and to emphasize the importance of taking extraordinary differential diagnoses into account
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