An unusual case of retained bullet in the heart since World War II: a case report

K.M. Burgazli, S.M. Cetin, N. Atmaca, M. Mericliler, N. Evagelopoulos, S.H. Daebritz

Wuppertal Research and Medical Center, Department of Innere Medizin, Angiology Wuppertal, Germany. mehmetburgazli@hotmail.de

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• Cardiac surgery

Although bullets penetrating into the heart are usually known as fatal, retained cardiac bullets can have a silent course without causing any cardiovascular complications. An 89 year-old patient with myocardial infarction was admitted to our department hemodynamically stable and widely awake. His electrocardiogram didn’t show any evidence of ischemia. Cardiac catheterization revealed a three-vessel coronary artery disease. In addition, a circular structure projected on the area of the marginal branch and the V. magna cordis. Removal of the bullet showed that three quarters of myocardium were involved without any perforation. The history of the patient revealed an injury under the heavy fire during World War II.

Thus, this case demonstrates that bullets can remain asymptomatic within in the heart for decades. The patient was dis-charged home at the 10th postoperative day after having an uneventful clinical course.

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