• Bonnie Mathews, Cindy Chen, and Michael Fahey.
• Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
• J Emerg Med. 2020 Oct 1; 59 (4): e127-e130.

BackgroundIntracardiac foreign bodies have been described in the literature, however, they are rare entities, particularly in pediatric patients. We present a case of a teenage boy diagnosed with perimyocarditis who was found to have an unexpected underlying etiology: an unknowingly swallowed sewing pin.Case ReportA 17-year-old boy presented to the Emergency Department with 3 days of chest pain suggestive of perimyocarditis, in the absence of prodromal symptoms or trauma. Electrocardiogram at the time of presentation demonstrated diffuse ST-segment elevation consistent with perimyocarditis. A chest radiograph was significant for a linear density in the anterior mid chest, concerning for foreign body. Chest computed tomography confirmed the presence of a 3.5-cm linear metallic foreign body within the right ventricle. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case demonstrates the need to consider alternative etiologies for perimyocarditis, especially in the absence of the typical prodromal symptoms. In addition, it highlights the potential devastating complications of foreign body ingestion and challenges the paradigm that ingested sharp linear foreign bodies < 5 cm in length rarely cause problems.Copyright © 2020 Elsevier Inc. All rights reserved.

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