Fish bone-induced myocardial injury leading to a misdiagnosis of acute myocardial infarction: A case report  

作　　者：Qian-Qian Wang Yi Hu Liang-Feng Zhu Wen-Jun Zhu Peng Shen 

机构地区：[1]Department of Intensive Care Unit,The First Hospital of Jiaxing,Jiaxing 314001,Zhejiang Province,China [2]Department of Cardiac Surgery,The First Hospital of Jiaxing,Jiaxing 314001,Zhejiang Province,China [3]Department of Cardiology,The First Hospital of Jiaxing,Jiaxing 314001,Zhejiang Province,China [4]Department of Ultrasound,The First Hospital of Jiaxing,Jiaxing 314001,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2019年第20期3335-3340,共6页世界临床病例杂志

基　　金：Supported by The Key Medical Disciplines of Jiaxing-Critical Care Med(Supporting Subject),No.2019-zc-12

摘　　要：BACKGROUND Acute chest pain(ACP)is very common among patients presenting to emergency departments.Nevertheless,ACP caused by esophageal foreign body is relatively rarely reported.CASE SUMMARY A 56-year-old man suffering from chest pain(increased pain for the last 9 h)was admitted to our hospital on October 25,2015.After undergoing physical examination and laboratory blood testing,he was diagnosed with acute anterior myocardial infarction.Consequently,the patient underwent emergency percutaneous coronary angiography;however,no myocardial infarction signs were observed.Later on,the patient experienced respiration failure and therefore was transferred to intensive care unit.Cardiac ultrasound showed pericardial effusion,which was considered as the cause of shock.He then underwent pericardium puncture drainage and the circulation temporarily improved.Nevertheless,persistent pericardial bleeding,unclear bleeding causes,and clot formation induced poor drainage led to worsening of cardiac tamponade symptoms.Consequently,the patient underwent emergency exploratory thoracotomy,which revealed a fish bone causing pericardial bleeding.The bone was removed,and the damaged blood vessels were mended.Eventually,the patient was discharged in good clinical condition.CONCLUSION For patients with chest pain,it is necessary to consider the possibility of foreign body in the esophagus or even in the heart.Careful history taking and the corresponding inspection can help to avoid unnecessary damage and safeguard patients from unnecessary pain.BACKGROUND Acute chest pain(ACP) is very common among patients presenting to emergency departments. Nevertheless, ACP caused by esophageal foreign body is relatively rarely reported.CASE SUMMARY A 56-year-old man suffering from chest pain(increased pain for the last 9 h) was admitted to our hospital on October 25, 2015. After undergoing physical examination and laboratory blood testing, he was diagnosed with acute anterior myocardial infarction. Consequently, the patient underwent emergency percutaneous coronary angiography; however, no myocardial infarction signs were observed. Later on, the patient experienced respiration failure and therefore was transferred to intensive care unit. Cardiac ultrasound showed pericardial effusion, which was considered as the cause of shock. He then underwent pericardium puncture drainage and the circulation temporarily improved.Nevertheless, persistent pericardial bleeding, unclear bleeding causes, and clot formation induced poor drainage led to worsening of cardiac tamponade symptoms. Consequently, the patient underwent emergency exploratory thoracotomy, which revealed a fish bone causing pericardial bleeding. The bone was removed, and the damaged blood vessels were mended. Eventually, the patient was discharged in good clinical condition.CONCLUSIONFor patients with chest pain, it is necessary to consider the possibility of foreign body in the esophagus or even in the heart. Careful history taking and the corresponding inspection can help to avoid unnecessary damage and safeguard patients from unnecessary pain.

关 键 词：CHEST pain Acute myocardial INFARCTION PERICARDIAL EFFUSION Fish bone Case report 

分 类 号：R54[医药卫生—心血管疾病]