Nail gun penetrating injury of the heart mimicking an acute coronary syndrome

We describe the case of a 75-year-old man admitted to hospital for chest pain and syncope. Physical examination was normal with evidence of a very small wound on the left chest. Considering the presence of multiple coronary risk factors, an acute coronary syndrome was initially suspected, but the el...

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Veröffentlicht in:International journal of emergency medicine 2010-06, Vol.3 (2), p.135-137
Hauptverfasser: Comoglio, Chiara, Sansone, Fabrizio, Boffini, Massimo, Ribezzo, Marco, Rinaldi, Mauro
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Sprache:eng
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Zusammenfassung:We describe the case of a 75-year-old man admitted to hospital for chest pain and syncope. Physical examination was normal with evidence of a very small wound on the left chest. Considering the presence of multiple coronary risk factors, an acute coronary syndrome was initially suspected, but the electrocardiogram (EKG) was normal and only a slight increase of cardiac enzymes was detected. The hypothesis of aortic dissection was also considered and in order to discriminate between the aortic and coronary syndrome, a thoracic and coronary computed tomography (CT) scan was performed. The CT scan showed a metallic structure, suggestive of a nail, about 6 cm in length, in the deep layers of the left ventricular wall and a small pneumothorax due to a lung lesion. The patient was therefore transferred to our department for urgent cardiac surgery that was performed without complications.
ISSN:1865-1372
1865-1380
1865-1380
DOI:10.1007/s12245-009-0152-5