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Correspondence
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Volume 352:2249-2250 May 26, 2005 Number 21
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Right Coronary Perforation Due to a Toothpick Ingested at a Barbecue

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To the Editor: Ingested toothpicks have often been reported as the cause of gastrointestinal injuries,1 and in one case a toothpick migrated into the pericardium, resulting in constrictive pericarditis.2 We report an unusual case of cardiac tamponade due to an ingested toothpick.

A 67-year-old woman with no pertinent medical history presented to the emergency department with chest pain and signs of cardiac tamponade (muffled heart sounds, low blood pressure, and vasoconstriction). The electrocardiogram showed Q waves in leads II, III, and aVF. The creatine kinase concentration was 736 U per liter (normal reference range, 20 to 160 U per liter), . . . [Full Text of this Article]



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