Englberger, Lars

Most, Henriette

Stortecky, Stefan

Wigger, Olivier

Bern Open Repository and Information System (BORIS)

source: https://doi.org/10.7892/boris.74074 | downloaded: 17.2.2023CARDIOVASCULAR FLASHLIGHT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .doi:10.1093/eurheartj/ehv171Cardiac perforation as a rare complication of acupunctureOlivier Wigger1, Stefan Stortecky1*, Henriette Most2, and Lars Englberger21Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Bern 3010, Switzerland; and 2Department of Cardiovascular Surgery,Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland* Corresponding author. Email: stefan.stortecky@insel.chA previously healthy 51-year-old female wasreferred to the emergency department withongoing chest pain and dyspnoea. The ECGshowed non-significant ST-segment elevationsand PQ depression in the limb leads withreciprocal PQ elevation and ST depression inaVR (Panel A), suggestive for acute pericarditis.As repetitive blood sampling assessment showeda relevant increase in high-sensitivity Troponin,a coronary angiography was performed to ruleout significant coronary artery disease. Whilethe coronary arteries were free from atheroma-tous plaques, the fluoroscopic images showed aneedle-shaped foreign body projecting on theleft ventricle (Panel B). Transthoracic echocardi-ography was not able to identify the cause of theforeign body, but computed tomography scanconfirmed the presence of a needle-shaped radi-opaque structure perforating the left ventricleand protruding into the left lower lobe of the lung (Panel C). After discussing the imaging findings as a potential reason for the clinical symp-toms, the patient immediately mentioned an acupuncture treatment some days ago. Acupuncture was performed by a non-professionaland close friend to treat her chronic musculo-skeletal pain. Cardiac surgery was immediately performed, during which a left-sidedhaemothorax was evacuated and the thin needle (0.2 × 75 mm) completely removed without cardiopulmonary bypass (Panel D).Patient recovery was fast and uneventful and she was discharged on Day 4 after surgery.Thoracic therapeutic acupuncture could be associated with potential life-threatening complications in inexperienced hands and shouldonly be performed by trained experts in the field.Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2015. For permissions please email: journals.permissions@oup.com. European Heart Journal Advance Access published May 20, 2015 by guest on December 9, 2015http://eurheartj.oxfordjournals.org/Downloaded from 

Cardiac perforation as a rare complication of acupuncture

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