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Sewing Needle in the HeartClinical History: A sewing needle which had accidentally penetrated through the chest wall and got embedded in the left ventricular myocardium was surgically removed without the use of cardiopulmonary bypass . Findings: CT scan of the chest showing the needle lying in the left ventricle Diagnosis: Sewing Needle in the Heart Discussion:
Cardiac injuries with sharp pointed objects are not uncommon.Most of these are accidental or self-inflicted due to an underlying psychiatric illness. They have also been reported following angiographic procedures, intravenous injections, and puncture with acupuncture needles. Determination of the exact location of the needle body is important to ensure complete removal. This can usually be accomplished by a combination of CT scan of the chest, two-dimensional echocardiography, and fluoroscopy.
References / Suggested Reading: 1) Inoue T, Iemura J, Saga T. Delayed cardiac tamponade caused by self-inserted needles. Can J Cardiol 2003;19:306–8. 2) Jamilla FP, Casey LC. Self-inflicted intramyocardial injury with a sewing needle: a rare cause of pneumothorax. Chest 1998;113:531–4.
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Cardiac foreign bodies are uncommon. Another source can be bullet injuries. Sometimes bullets get lodged in the pulmonary artery ( Bullet Emboli) or myocardium.
Dr. Vikram Singh Dogra
Professor of Radiology, Urology & BME
Associate Chair for Education and Research.
Department of Imaging Sciences
University of Rochester School of Medicine