Kiliçaslan Fethi, Aparci Mustafa, Uz Omer, Oztürk Ersin
Department of Cardiology, Haydarpaşa Training Hospital, Gülhane Military Medical School, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2012 Mar;40(2):171-3. doi: 10.5543/tkda.2012.01812.
Penetrating injuries to the myocardium are rare but potentially lethal. We present a 22-year-old asymptomatic male patient with a pellet lodged in the myocardium as a result of a gunshot that took place three years before. His medical history was otherwise unremarkable. The chest X-ray showed multiple pellets within the thorax. Computed tomography of the chest demonstrated many pellets in the anterior chest wall, while a few lodging within the lung tissue and one within the myocardium. Transthoracic echocardiography showed a pellet within the left ventricular myocardium presenting as an acoustic shadowing. Thickening of the adjacent pericardium was also noted. There were no signs of constrictive pericarditis or regional wall motion abnormality. Holter monitoring and treadmill exercise test did not show any abnormal finding. The patient was included in a periodic follow-up program.
心肌穿透伤虽罕见但有潜在致命性。我们报告一名22岁无症状男性患者，其心肌内有一枚三年前因枪伤留存的弹丸。他的病史无其他异常。胸部X线显示胸腔内有多发弹丸。胸部计算机断层扫描显示前胸壁有许多弹丸，少数位于肺组织内，一枚位于心肌内。经胸超声心动图显示左心室心肌内有一枚弹丸，表现为声影。还注意到相邻心包增厚。没有缩窄性心包炎或局部室壁运动异常的迹象。动态心电图监测和跑步机运动试验未显示任何异常发现。该患者被纳入定期随访计划。
