Penetrating nail injuries may occur accidentally and penetrating heart injuries by the nails are uncommon. Finding foreign bodies in the heart may be challenging during the operation due to the movement of the foreign body. A 34-year-old construction worker was brought to the emergency department with a history of accidental injury with a nail. A transthoracic echocardiogram showed pericardial effusion with tamponade. An urgent operation was performed via median sternotomy. The whole thoracic organs including the heart and the right lung was palpated, but no foreign body was able to be detected. Perioperative transesophageal echocardiography did not show any foreign body. The operation was finished. In the day of surgery a computed tomography scan of the thorax showed a foreign body in the right posterior basal segment of the lung. The second operation was performed via a right thoracotomy at the postoperative fifth day. Foreign body was palpated in the posterior basal segment of the right lung and it was removed.

Keywords : Embolus; foreign body migration; heart