Image in Cardiology
The lost needle of a seamstress
A agulha perdida de uma costureira
Ana Rita Godinho
, Mariana Vasconcelos, Inês Rangel, Domingos Magalhães, Maria Júlia Maciel
Corresponding author
Serviço de Cardiologia, Hospital de São João, Porto, Portugal
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(B) Coronária esquerda (projeção OAD 30°; CAUD 10°): sem lesões significativas, revelando a presença de uma agulha de costura no hemitórax esquerdo. (C) Agulha de costura ampliada (projeção AP 0° 0°). (D) TC torácica (plano sagital): agulha de costura em topografia subpleural, posterior ao segmento apical do lobo inferior esquerdo. (E) TC torácica (janela pulmonar, plano coronal): agulha de costura, medindo 40<span class="elsevierStyleHsp" style=""></span>mm, orientada no sentido crânio‐caudal. 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Multislice computed tomography angiography: volume rendering (B) and maximum intensity projection reconstructions (C), revealing the radiopaque indicators (arrows) at the edges of the scaffold. 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class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Mariana" "apellidos" => "Vasconcelos" ] 2 => array:2 [ "nombre" => "Inês" "apellidos" => "Rangel" ] 3 => array:2 [ "nombre" => "Domingos" "apellidos" => "Magalhães" ] 4 => array:2 [ "nombre" => "Maria Júlia" "apellidos" => "Maciel" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Serviço de Cardiologia, Hospital de São João, Porto, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "A agulha perdida de uma costureira" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1174 "Ancho" => 1800 "Tamanyo" => 290816 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Right coronary artery in left anterior oblique projection at 45°, caudal 10°, showing 60% proximal stenosis and 70% stenosis in the posterolateral branch; (B) left coronary artery in right anterior oblique projection at 30°, caudal 10°, showing no significant lesions but revealing a sewing needle in the left hemithorax; (C) anteroposterior view, 0° 0°, showing magnified image of the needle; (D) thoracic computed tomography (CT), sagittal plane, showing the needle in subpleural position, posterior to the apical segment of the left inferior lobe; (E) thoracic CT, pulmonary window, coronal plane, showing the needle, 40 mm in length, in cranial-caudal orientation; (F) myocardial scintigraphy: after exercise (above) and at rest (below), documenting a lateral perfusion defect with significant reversibility.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 61-year-old seamstress with hypertension, dyslipidemia and diabetes was referred to our hospital for chest pain and a positive exercise test. The ECG and transthoracic echocardiogram were normal. Coronary angiography revealed 60% stenosis in the proximal right coronary artery and 70% stenosis in the posterolateral branch (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A). A sewing needle was detected in the left hemithorax (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B and C). Further investigation by thoracic computed tomography (CT) confirmed the location of the needle in the apical segment of the left inferior lobe (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D and E). When questioned, she mentioned an episode of acute pricking pain six months previously, which resolved spontaneously. A conservative approach, with imaging surveillance, was adopted by the thoracic surgery team given the absence of symptoms related to the foreign body. Repeat CT performed four weeks later showed the sewing needle in the same location. A lateral perfusion defect was identified by scintigraphy (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>F) related to the posterolateral branch lesion. Medical treatment was the approach adopted in view of the caliber of the vessel, and the patient has remained asymptomatic.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-01-19" "fechaAceptado" => "2014-03-06" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Godinho AR, Vasconcelos M, Rangel I, et al. A agulha perdida de uma costureira. Rev Port Cardiol. 2014;33:573–574.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1174 "Ancho" => 1800 "Tamanyo" => 290816 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Right coronary artery in left anterior oblique projection at 45°, caudal 10°, showing 60% proximal stenosis and 70% stenosis in the posterolateral branch; (B) left coronary artery in right anterior oblique projection at 30°, caudal 10°, showing no significant lesions but revealing a sewing needle in the left hemithorax; (C) anteroposterior view, 0° 0°, showing magnified image of the needle; (D) thoracic computed tomography (CT), sagittal plane, showing the needle in subpleural position, posterior to the apical segment of the left inferior lobe; (E) thoracic CT, pulmonary window, coronal plane, showing the needle, 40 mm in length, in cranial-caudal orientation; (F) myocardial scintigraphy: after exercise (above) and at rest (below), documenting a lateral perfusion defect with significant reversibility.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003300000009/v1_201410030041/S217420491400172X/v1_201410030041/en/main.assets" "Apartado" => array:4 [ "identificador" => "28321" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Image in Cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003300000009/v1_201410030041/S217420491400172X/v1_201410030041/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491400172X?idApp=UINPBA00004E" ]
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| 2015 April | 33 | 15 | 48 |
| 2015 March | 36 | 9 | 45 |
| 2015 February | 34 | 4 | 38 |
| 2015 January | 32 | 10 | 42 |
| 2014 December | 55 | 14 | 69 |
| 2014 November | 47 | 18 | 65 |
| 2014 October | 133 | 67 | 200 |
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