Postmortem Identification of a Foreign Body in the Heart: A Case Report.

Abstract

The presence of a foreign body in the heart have been reported, mostly in adults. Deaths and injuries can result from the breakage or rupture of angiography catheters. We present a case in which an angiocath tip was identified in the right ventricle of a pediatric patient, and the patient died as a result thereof. As no similar cases have been reported, we would like to draw attention to this subject. A 4.5-month-old female patient who was hospitalized 3 times during her life had a history of peripheral venous access establishment in the extremities with angiocatheters. During these hospital admissions, a central catheter was not inserted, and no additional problems were identified. Emergency personnel responded and found the patient at home, experiencing bradycardia and arrhythmia. She was resuscitated and taken to the hospital, where she died. The autopsy revealed, the tip of a 1.5 cm long, 1 mm wide lumen catheter had penetrated the right ventricular wall (Fig. 1) (Fig. 2), thus her death was attributed to complications that developed as a result of the peripheral vascular access catheter tip breaking and migrating to the right ventricle. Although the patient did not have an ECG, physical examination by the emergency ambulance personnel revealed an irregular and bradycardic heartbeat, suggesting that the child may have developed arrhythmia and atrioventricular conduction block. Health care professionals must check upon removal of peripheral intravenous access, and record whether the integrity of the peripheral catheter tip was compromised to prevent similar events in future. Fig. 1 Angiocath tip piercing the right ventricular wall and exiting the heart Fig. 2 a A 1.5 cm long, b 1 mm wide lumen catheter tip penetrating the right ventricular wall.