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Bullet embolization to a coronary artery
1Department of Cardiothoracic and Vascular Surgery, Hospital Centro Medico de Caracas, San Bernardino, Venezuela.
Insights
A pellet lodged in a coronary artery caused a heart attack in a 48-year-old man. This rare case highlights the risk of coronary artery embolization from gunshot wounds.
Area of Science:
- Cardiology
- Trauma Surgery
Background:
- Coronary artery embolization is a rare but serious complication.
- Foreign bodies can travel through the arterial system.
Observation:
- A 48-year-old male presented with chest pain and myocardial infarction following pellet wounds.
- Radiographic imaging revealed a pellet near the heart.
- Coronary arteriography identified a pellet occluding the posterior descending artery.
Findings:
- The pellet acted as a foreign body causing complete occlusion of the posterior descending branch of the right coronary artery.
- This resulted in an inferior myocardial infarction.
Implications:
- This case demonstrates intravascular arterial embolization in the coronary circulation, a previously unreported site for pellet emboli.
- Highlights the importance of considering vascular injury in penetrating chest trauma.
Abstract:
A rare case of coronary artery embolization is presented. A 48-year-old man arrived with multiple pellet wounds, severe chest pain, and an inferior myocardial infarction. Chest roentgenograms showed one of the pellets overlying the cardiac shadow, and coronary arteriography revealed complete occlusion of the posterior descending branch of the right coronary artery with a radiopaque foreign body, which corresponded exactly to the pellet first seen. Intravascular arterial embolization of small caliber bullets has been reported in the abdomen, lower extremities, and the carotid territory. Here we report such an event occurring in the coronary circulation.