Unveiling an Asymptomatic Air-Gunshot Injury (JACC Case Reports May 2024)-Article: Unveiling an Asymptomatic Air-Gunshot Injury

Article: Unveiling an Asymptomatic Air-Gunshot Injury

Pdf Summary

A 41-year-old man presented to the Cardiac Intensive Care Unit after an accidental intramyocardial injury from an air-gunshot blast with a 4.5-mm pellet. The pellet traversed his left arm and lodged in the interventricular septum. Despite intense pain, he remained stable with no signs of active bleeding or infection. After a thorough risk-benefit analysis, a nonoperative approach was favored over surgical extraction, with no prophylactic antibiotics or colchicine administered. The patient was asymptomatic and discharged in excellent condition after one week. Follow-up at one month showed no signs of sepsis or complications, with the pellet position unchanged. This case highlights the challenges in managing penetrating cardiac injuries with retained foreign bodies, emphasizing the importance of multidisciplinary collaboration in decision-making. Despite the historically high mortality rates associated with such injuries, this patient's successful outcome suggests that nonsurgical management can be feasible in certain cases, underscoring the need for further research and evidence-based guidelines to improve patient outcomes. Regular surveillance through clinical assessments, CT scans, and echocardiograms is crucial to monitor for potential long-term complications. This case provides valuable insights into the management of air-gunshot cardiac injuries and calls for continued efforts to enhance patient care in similar scenarios.

Keywords

Cardiac Intensive Care Unit

intramyocardial injury

air-gunshot blast

interventricular septum

nonoperative approach

penetrating cardiac injuries

retained foreign bodies

multidisciplinary collaboration

nonsurgical management

long-term complications