Left Ventricular Bullet Embolus: A Case Report and Review of the Literature

Joseph M Galante, Jason A. London

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Missile embolization to the heart occurs infrequently in penetrating trauma. The lack of a concentrated experience at any single institution contributes to the controversies pertaining to diagnostic and therapeutic approaches to management. The objective of this study was to describe a case of a left ventricular bullet embolus and provide a detailed diagnostic and therapeutic framework for management of intracardiac projectiles. Initial management of a patient with suspected intracardiac projectiles is dictated by his or her hemodynamic status. Unstable patients generally require operative intervention. In the stable patient, associated injuries must be sought. Localization of the projectile can be aided by echocardiogram, fluoroscopy, or angiography. Definitive management is individualized, and can range from observation to percutaneous or operative extraction. The decision depends on the cardiac chamber involved, the patients' symptoms, and the projectile's size, shape, and location within the chamber. Missile embolus to the heart is an infrequent occurrence, but when found presents a diagnostic and therapeutic challenge. Management strategies should be individualized. A detailed management algorithm is provided.

Original languageEnglish (US)
Pages (from-to)25-31
Number of pages7
JournalJournal of Emergency Medicine
Volume39
Issue number1
DOIs
StatePublished - Jul 2010

Keywords

  • bullet
  • embolus
  • heart
  • management
  • penetrating trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Medicine(all)

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