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Nail to the heart: no big deal. A rare case of post-traumatic pericarditis
  1. Dominika M Zoltowska1,
  2. Yashwant Agrawal2,
  3. Jagadeesh K Kalavakunta3,
  4. Vishal Gupta3
  1. 1Internal Medicine, Western Michigan University School of Medicine, Kalamazoo, Michigan, USA
  2. 2Internal medicine/Pediatrics, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, Michigan, USA
  3. 3Cardiology, Borgess Medical Center/Michigan State University, Kalamazoo, Michigan, USA
  1. Correspondence to Dr Dominika M Zoltowska, dominika.zoltowska{at}


This is a unique case report of a 32-year-old man who presented with pneumatic nail gun injury to his right chest at work. He removed the nail and continued to work through the day. With continued chest pain, he presented to the emergency room and an echocardiogram revealed moderate-size pericardial effusion. He was managed conservatively as he was haemodynamically stable. Serial echocardiograms revealed slow resolution of the effusion over 3 days. At his 3-month follow-up appointment, there was complete resolution of his effusion. This case highlights the importance of obtaining imaging studies in penetrating chest wall injuries and utilisation of medications to prevent expected complications.

  • pericardial disease
  • clinical diagnostic tests

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  • Contributors DMZ was a resident admitting the patient. YA was a resident participating in the patient’s care during admission. VG was an attending cardiologist responsible for the patient’s care during the hospitalisation. JKK was a cardiologist who followed up with the patient in a cardiology clinic.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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