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Constrictive Pericarditis Long after a Gunshot Wound.
Jung-Ho Choi1, Jae-Sun Uhm1, Sang-Eun Lee1
1Department of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Korean Circulation Journal
|August 5, 2015
Summary
A retained bullet caused constrictive pericarditis in a 69-year-old man. Surgical removal of the bullet and radiofrequency ablation for atrial flutter resolved the condition without complications.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Case Reports
Background:
- Constrictive pericarditis is a rare condition caused by pericardial thickening, often post-inflammatory.
- While uncommon, foreign bodies like bullets can lead to chronic constrictive pericarditis after long asymptomatic periods.
Purpose of the Study:
- To report a case of constrictive pericarditis secondary to a retained bullet.
- To highlight the diagnostic and therapeutic approach for this rare etiology.
Main Methods:
- Cardiac computed tomography (CT) for bullet localization.
- Transthoracic echocardiography for assessing pericardial thickening and cardiac function.
- Surgical bullet removal and radiofrequency ablation for atrial flutter.
Main Results:
- A 69-year-old patient presented with atrial flutter and findings consistent with constrictive pericarditis.
- Cardiac CT identified a bullet near the right atrium, presumed to be from a 1950 gunshot injury.
- Successful surgical removal of the bullet and radiofrequency ablation were performed.
Conclusions:
- Long-term retained foreign bodies, such as bullets, can be an unusual cause of constrictive pericarditis.
- A multidisciplinary approach involving imaging, cardiology, and surgery is crucial for managing such complex cases.
- Prompt diagnosis and intervention can lead to favorable patient outcomes.
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