CTICasesIatrogenic RV Perforation with Hemopericardium from Retained Thrombolysis Catheter
Imaging findings
A portable chest radiograph shows a much larger cardiac contour compared to baseline. CT reveals very high attenuation pericardial effusion (hemopericardium) and a metallic wire (thrombolysis catheter) tangled in the right ventricle, perforating it in three different places. A portion of the catheter has embolized into the right lower lobe pulmonary artery, and characteristic markers on the catheter are visible.
Key takeaways
Acute cardiac contour enlargement should prompt strong suspicion for pericardial effusion. Retained intravascular devices, even after months, can lead to severe and delayed complications like cardiac perforation and hemopericardium. Always be vigilant for foreign bodies, especially when there's an acute change in cardiac silhouette, and clarify the completeness of device removal.
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