Conclusions:
This case illustrates the importance to include needle embolization to
the heart as a potential differential diagnosis in a patient with past
or current drug abuse presenting with angina or dyspnea. It also
highlights the lack of guidelines and discusses key considerations in
withholding treatment in asymptomatic patients, as well as treatment
considerations in a symptomatic patient (e.g. possible cardiac
tamponade, infections, embolisms, or arrhythmias) including sternotomy
with exploration of the mediastinal cavity.