Foreign bodies in the heart

Echocardiography. 2015 Feb;32(2):365-71. doi: 10.1111/echo.12795. Epub 2014 Oct 7.

Abstract

Background: Foreign bodies in the heart are rare, may reach the heart by different ways, and cause serious complications. X-ray, computerized tomography, and echocardiography are main diagnostic modalities. Foreign body can be removed surgically, percutaneously or can be managed conservatively. In this work, we analyzed 100 published cases of a foreign body in the heart and 4 cases that were identified in our hospital.

Methods: We searched the literature for foreign body in the heart and found 100 published previously cases. Additional 4 cases were identified in our echo laboratory. A total series of 104 patients with a foreign body in the heart were analyzed for the etiology, clinical presentation, symptoms, complications and management.

Results: Mean patients' age was 46, there were more men than woman 73 versus 31 [P < 0.00005]. The most common foreign bodies were parts of inferior vena cava filters and devices implanted for relieving hydrocephalus. Foreign bodies in the heart were symptomatic in 56% of patients. Right heart chambers were occupied more often. A total of 20% presented within the first 24 hours and 30% of patients presented years after the penetration of the foreign body. A majority of foreign bodies reached the heart by migration [88%]. Mortality was reported in 4 patients [3.8%]. Here 54% of the patients underwent surgical and 29% percutaneous removal of the foreign body, while 14% were followed conservatively.

Conclusion: Foreign bodies in the heart may present with a wide variety of symptoms. Physicians should be aware of this rare and peculiar complications which may be fatal. Larger devices may result in more severe complications.

Keywords: echocardiography; foreign body; heart.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Catheters
  • Echocardiography, Doppler
  • Equipment Failure
  • Female
  • Foreign Bodies / diagnostic imaging*
  • Foreign Bodies / surgery
  • Foreign Bodies / therapy*
  • Foreign-Body Migration
  • Heart*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Failure
  • Stents
  • Wounds, Gunshot / diagnostic imaging
  • Wounds, Gunshot / surgery
  • Young Adult