Key result
Surgical extraction resolves occult foreign body pericarditis initially presenting as STEMI mimic.
Why the study?
Diagnostic confusion and treatment delays may arise in patients presenting with chest pain, elevated cardiac biomarkers, and ST-segment elevation due to overlapping features of acute pericarditis and myocardial infarction.
Case Report (n=1)
This case highlights the importance of thorough history taking and multimodality imaging (bedside echocardiography and chest radiography) to differentiate acute coronary occlusion from other causes of ST-segment elevation, such as foreign body-induced pericarditis.
Occult foreign body pericarditis may mimic STEMI; single case leaves open validation of expanded differentials in larger cohorts.
BACKGROUND: We report a case of acute pericarditis caused by an occult penetrating foreign body manifesting as an ST-segment elevation myocardial infarction mimic. CASE SUMMARY: The patient initially presented with chest pain, increased cardiac troponin I, and ST-segment elevation. Following emergency intravenous thrombolysis and urgent coronary angiography, an alternative etiology was suspected. Subsequent verification of the medical history and imaging examinations ultimately identified the culprit: a nail. The patient received prompt treatment, and the pericardial foreign body was successfully extracted. DISCUSSION: Acute pericarditis and acute myocardial infarction are common causes of acute chest pain. Diagnostic confusion and treatment delays may arise due to overlapping symptoms, elevation of cardiac biomarkers, ST-segment elevation, cognitive bias, and incomplete history taking. TAKE-HOME MESSAGES: This case highlights the value of bedside echocardiography combined with chest radiography. In patients with suspected ST-segment elevation myocardial infarction, it is crucial to differentiate acute coronary occlusion from other causes, especially foreign body-induced pericarditis.
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贺晓玲 et al. (2026) conducted a case report in Acute pericarditis mimicking ST-segment elevation myocardial infarction (n=1). Extraction of pericardial foreign body (nail) was evaluated. An occult penetrating foreign body (a nail) causing acute pericarditis and mimicking an ST-segment elevation myocardial infarction was successfully identified and surgically extracted.
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