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(Circulation. 2006;114:e623-e626.)
© 2006 American Heart Association, Inc.

Images in Cardiovascular Medicine

Right Ventricular Acupuncture Needle Embolism Detected on Coronary Computed Tomography Angiography

Young Jin Kim, MD; Ji Youn Kim, MD; Byoung Wook Choi, MD, PhD; Ji Eun Nam, MD; Tae Hoon Kim, MD, PhD; Kyu Ok Choe, MD, PhD

From Department of Radiology, Yonsei University College of Medicine, Severance Hospital (Y.J.K., J.Y.K., B.W.C., J.E.N., K.O.C.), and Yongdong Severance Hospital (T.H.K.), Seoul, Korea.

Correspondence to K.O. Choe, MD, PhD, Department of Radiology, Yonsei University College of Medicine, Severance Hospital, 134 Sinchon-dong, Seodaemun-gu, Seoul 120-752, Korea. E-mail kochoe@yumc.yonsei.ac.kr

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 70-year-old man presented to the emergency department with dyspnea and chest discomfort. He had a history of chronic obstructive lung disease, and 1 year before presentation he had been hospitalized with pneumothorax. ECG revealed right-axis deviation, and cardiac biomarkers were negative. He underwent computed tomography coronary angiography to rule out ischemic heart disease, which revealed normal coronary arteries but a metallic density in the right ventricular wall (Figure 1). There was no detectable pericardial effusion. Another metallic density was also noted in the small branch of the pulmonary artery at the right upper lobe (Figure 2). The patient had undergone gold-needle acupuncture 1 year before, and a chest radiograph showed numerous gold needles in the neck, chest wall, and abdominal wall (Figure 3). The 3-dimensional volume-rendered images showed a thin linear metallic density in the right ventricular wall that was the same shape and size as the ones in the chest wall (Figure 4).

View larger version (93K):   Figure 1. Coronary computed tomography angiography (A) and precontrast image for calcium scoring (B) show a thin linear metallic density in the right ventricular wall.

View larger version (94K):   Figure 2. Mediastinal setting (A) and lung setting (B) images of precontrast computed tomography demonstrate another metallic density (white arrows) in the small branch of the pulmonary artery at the right upper lobe, suggestive of metallic foreign-body embolism. Numerous metallic densities (black arrows) are seen in the chest wall.

View larger version (102K):   Figure 3. Chest radiograph reveals numerous thin linear metallic densities in the neck . . . [Full Text of this Article]