Doctors in China have described an extremely rare case in which they found a 36mm-long sewing needle stuck into the left ventricle of a patient’s heart – a 35-year-old man with an intellectual disability who was experiencing painful urination and blood in the urine.
When he came to the hospital seeking treatment, however, his vital signs were in a healthy range. Somehow, his cardiovascular system was still functioning.
But when doctors imaged his chest, they noticed a peculiar shadow over his heart.
A further CT scan of the chest, abdomen, and pelvis revealed several metallic foreign bodies within his body: they were in his abdominal wall, pelvis, bladder wall and lumen, hip bone, hip muscle, and penis.
One particularly threatening needle, measuring 36mm, had punctured the fluid-filled sac around his heart. Its sharp tip extended quite far into the left ventricular cavity.
The case study is published in BMC Cardiovascular Disorders, with written informed consent from the patient’s father.
The needle in the heart ultimately required surgery.
Doctors feared the metal foreign body would migrate or cause a rupture or infection. Upon closer inspection, the patient's left ventricle was noticeably dilated and showed early signs of abnormality.
Once in the operating room, doctors found a dangerous situation beyond the heart. The needles penetrating the patient's bladder wall had visible stone-like encrustations on their surfaces.
Worried about the risk of intractable haemorrhage and urinary leakage, the surgical team decided to remove the needle in the heart first. They then removed those in the bladder at a later date.
The patient has recovered well, although it remains unclear how the needles got into his body.
“Although multiple systemic needles were confirmed, neither the patient nor his family could clarify their origin,” note the doctors at Hunan Provincial People’s Hospital.
It is possible they were self-inflicted. The deliberate insertion of foreign objects into the body is an extreme form of self-injury sometimes referred to as self-embedding behaviour.
It can be linked to psychiatric conditions, like schizophrenia, or mental health disorders, like depression.
The patient’s history suggests he may have engaged in self-embedding behaviour before. Two years previously, the young man had had two needle-like objects removed from his abdomen.
His most recent doctors, however, did not have access to these past medical records, and it is unclear whether these prior needles were deliberately or accidentally inserted.
Because the patient had no heart-related symptoms, diagnosis was extra challenging. Doctors are not often on the lookout for cases of self-embedding, let alone those involving the heart.
A 2024 review found that since 1967, there have been only 34 reported cases of needles being introduced into the heart as a form of self-injury.
The patient only sought medical assistance when he started experiencing chest pain.
“Presumed self-insertion of cardiac foreign bodies in patients with cognitive impairment can be clinically occult, requiring a high index of clinical suspicion when a definitive history is difficult to obtain,” concluded the doctors in China.
Symptoms are not guaranteed.
Study details
Multi-organ needle foreign bodies with postoperative left ventricular apical outpouching and suspected mural thrombus: a case report
Yingxin Ren, Xian Ji, Juanjuan Xie et al.
Published in BMC Cardiovascular Disorders on 7 September 2026
Abstract
Rationale
Cardiac foreign bodies (CFBs) resulting from potential self-insertion behaviours are clinically rare and diagnostically challenging. In patients with cognitive impairment, obtaining a precise etiology can be complex due to an unclear medical history. While surgical removal is the definitive treatment, the dynamic evolution of secondary structural sequelae warrants detailed investigation. This study highlights the diagnostic value of multimodal imaging in monitoring localised myocardial wall abnormalities and the progression of remodelling throughout the clinical course.