Introduction
A foreign body or a foreign matter refers to anything that enters the body through external sources either due to accident or on purpose. A foreign body reaching the heart is rare and difficult but is also possible. Foreign bodies can reach the heart via several alternative routes and pose a problem.
The foreign body is either removed surgically or can also be managed without any therapy or treatment in highly mild cases. There are several methods to diagnose the presence of a foreign body that include radiography and physical examination. When present in the heart, foreign bodies can display a range of signs and symptoms. Health care providers should be aware of the threat a foreign body can cause to the heart and neighboring structures.
What Causes Foreign Body to Reach the Heart?
It is crucial to be aware of a foreign body in the heart and not mistake it for a typical heart structure. There are various ways of a foreign body entering the heart, such as those mentioned below. It should be noted that a foreign matter can possibly enter the human body due to an unknown blunder, trauma, or routes of self-infliction.
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Insertion of needles during acupuncture.
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Bullet shots.
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Sewing needles.
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Fragments of Kirchner (orthopedic) wires.
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Grenade.
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Venous insertion of catheter devices.
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Aspiration of foreign bodies.
There are multiple ways foreign bodies can reach the heart directly or indirectly. A foreign body can be swallowed or ingested and may reach the heart through various routes within one's blood vessels. Additionally, a foreign body may be used for some purpose in another part of the body but, due to mishandling and carelessness, may move inside the body and lodge within the heart. These are the reasons why there are not any strong determiners of foreign bodies reaching the heart.
Can a Foreign Body in the Heart Be Diagnosed?
There are several technical ways to diagnose the presence of a foreign body. X-rays, computed tomography (CT scan), echocardiography are some of the vital diagnostic tools. Transthoracic echocardiography or TTE has proven to be a highly effective and sensitive tool for locating a foreign body as well as determining its size and extent of mobility with almost 100 % accurate results.
It should be noted that a foreign body in the heart or any other part of the body should be described to the physician for proper diagnosis in case the insertion was intentional. This truly helps in early diagnosis and successful removal through various measures that may not be quite invasive in nature.
What Are Signs and Symptoms of a Foreign Body in the Heart?
Determining the exact location of a foreign body in the heart remains a vital aspect of understanding the nature of discomfort it causes to a person. It has been studied that most of the foreign bodies in the heart get stuck in the right lower chamber, namely, the right ventricle, whereas the right above compartment (atrium) receives the least amount of foreign matter.
It has also been found that patients experience pain and discomfort and are more vulnerable when the foreign body is located on the external structures of the heart, such as the cardiac muscles and cardiac blood vessels, instead of intracardiac lodgment. This is because damage to the external structures of the heart can lead to further complications such as cardiac tamponade, which means tearing of heart muscles, formation of sacs and pouches that may get filled with fluid and blood, etc. The signs and symptoms may vary depending on the location of the foreign body and may mimic the clinical manifestations of other cardiovascular conditions.
How Can a Cardiac Foreign Body Be Treated?
It is essential to be aware of the location of the foreign body in order to go ahead with a successful treatment strategy. The treatment of a foreign body being located intracardially is a topic of controversy due to the multiple risks and complications it possesses. Additionally, patients who have been proven to be present with a foreign body in the heart but do not show any signs of discomfort or complaint can be left untreated provided that they follow up with their healthcare providers routinely. Conservative management of a cardiac foreign body is not very possible due to the extent of the condition. This implies that timely diagnosis and accurate results are crucial in cardiac foreign body management plans. It is also suggested to surgically remove any foreign body present anywhere in the body before it reaches the heart and vice versa.
A snare catheter or a venous catheter is a device that has currently proven potential in removing foreign bodies from veins and arteries. This is why snare catheter retrieval is mostly successful. However, if the diagnosis is late, even snare catheters would not be able to remove the foreign body. Over time, the foreign particle adheres and imbibes within the cardiac walls, leaving snare catheters no space to catch the foreign body.
Conclusion
The presence of a foreign matter in the heart is sporadic. It can also happen that a foreign substance elsewhere in the body can migrate and lodge inside the heart. Accurate knowledge of the presence of a foreign cardiac body calls for thorough medical history. Awareness of the multimodality diagnostic tools amongst physicians is crucial, and one should not be shy to use these technologies for successful treatment strategies extensively.
The final decision to interject the foreign body by invasive or non-invasive methods should be made based on the signs, symptoms, and complications the foreign body reveals in the current state and the long run. Whenever there is a possibility of a fatal outcome, surgical removal of the foreign body should not be thought twice. The diagnosed cardiac foreign body can be 100 % removed by various methods, as mentioned in this article, provided the diagnosis is prompt.
