Retained Bullet in the Interventricular Septum: A Rare Case of Cardiac Gunshot Injury for Conservative Management

Penetrating cardiac injuries due to gunshot wounds are often rapidly fatal, typically necessitating emergent surgical intervention. However, a small subset of hemodynamically stable patients can be conservatively managed with favorable outcomes. We present a rare case of a hemodynamically stable adult male who sustained a gunshot injury resulting in an embedded bullet in the heart. The patient was managed non-operatively after a comprehensive diagnostic evaluation, which included echocardiography, computed tomography, coronary angiography, and Holter monitoring. He remained asymptomatic over a 9-month follow-up period. The case highlights the feasibility of conservative management in carefully selected patients with penetrating cardiac injuries and emphasizes the importance of individualized imaging-guided decision-making. A long-term surveillance remains essential to identify delayed complications.