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Coronary embolization in bullet wounds: role of perioperative coronary angiography

Olivier Raisky1, Olivier Metton, Roland Henaine

  • 1Department of Cardiovascular Surgery, Hôpital Louis Pradel, Bron, France. oraisky@yahoo.com

The Annals of Thoracic Surgery
|June 26, 2007
PubMed

Insights

Chest gunshot wounds causing myocardial ischemia require prompt diagnosis. Emergency coronary angiography is crucial for identifying pellet-induced artery occlusion and guiding treatment.

Area of Science:

  • Cardiology
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Management of myocardial ischemia following chest gunshot wounds is not well-defined.
  • Prompt diagnosis and intervention are critical for patient outcomes.

Observation:

  • A patient presented with signs of cardiac tamponade and ST segment elevation after a gunshot wound.
  • Initial surgical exploration revealed no coronary artery lesions.

Findings:

  • Emergency coronary angiography identified acute right coronary artery occlusion by a pellet.
  • Successful surgical extraction of the pellet was performed on bypass.

Implications:

  • Coronary angiography should be considered in patients with chest pellet wounds and ischemic signs.
  • This diagnostic approach can reveal otherwise occult coronary artery injuries.

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