Key result
Surgical excision of a suspected left atrial myxoma reveals a transmigrated hypodermic needle.
Why the study?
Cardiac foreign bodies are rare and may initially present as cardiac masses, with few reported cases of migration from ingestion to the heart.
Case Report (n=1)
Ingested foreign bodies can migrate to the heart and mimic cardiac masses such as myxomas on echocardiography, requiring surgical intervention.
Answers are grounded in this paper and cite their sources.
Consider foreign body transmigration in psychiatric patients with unexplained cardiac masses; leaves open optimal diagnostic and management strategies.
BACKGROUND: Cardiac foreign bodies (FBs) are rare findings that may present as cardiac masses initially. Here, we present an exceptional and rare case of a hypodermic needle FB that transmigrated to the left atrium and presented as a left atrial mass. CASE SUMMARY: A 28-year-old woman with multiple psychiatric disorders including intentional FB ingestion and self-inflicting injuries presented to the emergency room with abdominal pain, nausea, vomiting, diarrhoea, and chest pain that radiated to the left arm and face for 2 weeks. An echocardiogram was performed revealing a left atrial mass concerning for myxoma. During the surgical removal of the mass, a hypodermic needle was found attached to the roof of the left atrium surrounded by thrombotic and fibrotic tissue, which was confirmed by pathology. DISCUSSION: Cardiac FBs are caused generally by penetrating wounds from direct trauma. Fewer cases have been reported regarding cardiac FB caused by ingestion from migration of the object to the heart. Signs and symptoms for cardiac FB may mimic those of cardiac masses. Cardiac FBs often require surgical intervention to avoid complications.
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Udemgba et al. (2020) conducted a case report in Cardiac foreign body / Left atrial mass (n=1). Surgical removal was evaluated. Surgical removal of a suspected left atrial myxoma in a 28-year-old woman revealed a transmigrated hypodermic needle foreign body surrounded by thrombotic and fibrotic tissue.
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