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Multiple Intracardiac Sewing Needles

3D Atlas - Unusual Clinical Cases



We report a case of multiple self inserted needles in the chest wall. A 48 year old woman affected by schizophrenia arrived to our observation after chest pain, ECG modifications and increase of cardiac enzyme, that deposed to acute coronary syndrome.

Chest X-ray    Chest X-ray

Chest X-ray. Six metallic density linear foreign bodies (2 of them over the cardiac silhouette) can be detected. In addition, a idro-pneumothorax in the left side with a modest pleural effusion at the bases and a pneumothorax at the right apex were found.

2DE in Emergency Room. Apical 4-chamber view (left upper panel) showing an echodense linear mass in the apical septum. Off-axix (right upper panel) and zoomed view (left lower panel) on paraapical area to show the needle transfixing the interventricular septum with a small left-to-right shunt at color Doppler (right lower Panel).







Three-dimensional echocardiography: volume rendering reconstruction of the sewing needle inside the heart. The eye of the needle is within the right ventricle, the needle enters the left ventricle through the interventricular septum, its left ventricular part is thickened by thrombus formation and its tip reaches the posterior wall of the left ventricle.


CT Volume Rendering Reconstruction of the Chest and the Heart

There are several needles in the chest and two entering the heart: one para-apical (arrow) which is the one seen at echocardiography; and another one at the level of the right vnetricular outflow tract (broken arrow).

CT Volume Rendering Reconstruction of the Chest and the Heart

CT Volume Rendering Reconstruction of the Chest and the Heart

CT Volume Rendering Reconstruction of the Chest and the Heart