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Penetrating wound of the heart manifested with peripheral embolism--case report

Milos Velinović1, Mile Vranes, Biljana Obrenović-Kirćanski

  • 1Faculty of Medicine, University of Belgrade, Belgrade, Serbia. velinovicsurg@gmail.com

Vojnosanitetski Pregled
|October 12, 2012
PubMed

Insights

A bullet lodged in the heart for four years traveled to the leg artery, causing ischemia. Successful surgical repair of the atrial septal defect and bullet removal highlights a rare, delayed complication of penetrating cardiac trauma.

Area of Science:

  • Cardiovascular Surgery
  • Trauma Surgery
  • Interventional Cardiology

Background:

  • Penetrating heart injuries, often involving the right atrium, carry significant morbidity and mortality.
  • Delayed complications of penetrating cardiac trauma are infrequently reported.
  • Atrial septal defects can serve as a pathway for cardiac foreign body migration.

Observation:

  • A 28-year-old patient presented with acute limb ischemia due to a bullet occluding the right common femoral artery.
  • The patient had a history of a gunshot wound to the chest four years prior.
  • Echocardiography revealed a secondary atrial septal defect, identified as the bullet's entry point into the arterial system.

Findings:

  • A bullet, lodged in the heart for four years post-injury, migrated through an atrial septal defect into the femoral artery.
  • The bullet's migration caused acute occlusion of the right common femoral artery, leading to limb ischemia.
  • Successful surgical management included embolectomy and repair of the atrial septal defect.

Implications:

  • This case highlights a rare, delayed presentation of penetrating cardiac trauma.
  • It underscores the potential for intracardiac foreign bodies to migrate years after the initial injury.
  • Successful surgical intervention demonstrates the feasibility of managing such complex, delayed complications.
Abstract

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