# Iatrogenic chest tube placement within the heart following a large pneumothorax

## TL;DR

A chest tube mistakenly placed inside a patient's heart after trauma highlights the need for image-guided procedures and careful monitoring.

## Contribution

This case report adds to the literature on rare iatrogenic cardiac injuries from chest tube placement.

## Key findings

- A chest tube was found inside the heart on CT imaging following placement for a pneumothorax.
- The patient recovered by postoperative day 13 and was discharged.
- The case emphasizes the importance of image-guided procedures and prompt imaging for complication detection.

## Abstract

This case report describes an uncommon occurrence of cardiac injury and perforation resulting from chest tube placement. The patient, a 44-year-old female, presented to the ED with severe blunt force trauma following a pedestrian motor vehicle collision. Imaging revealed a large pneumothorax and multiple fractures. Pulsatile bleeding was observed during chest tube placement, and the tube’s tip was later found on CT of the thorax to be located within the heart. Although the patient recovered by postoperative day 13 and was subsequently discharged, this case highlights the importance of performing this procedure under image-guidance, along with elucidating the critical role of serial thorough clinical evaluations and prompt imaging for early detection and management of complications.