Author + information
- Received October 17, 2013
- Accepted November 5, 2013
- Published online April 8, 2014.
A 61-year-old man with a known history of chronic hepatitis C was evaluated for chest pain due to non–ST-segment elevation myocardial infarction. On chest x-ray and angiography, many small radio-opaque foreign objects were scattered throughout the precordium. The patient stated that he had been shot by a shotgun 25 to 30 years ago during a fight. He had a prolonged hospitalization at that time, but had been asymptomatic ever since. The patient's echocardiogram revealed echo shadows (arrows) consistent with shotgun pellets in the interventricular septum, anterior mitral valve leaflet, and right ventricular outflow tract (A to C, Online Video 1). There was no significant valvular regurgitation (D, Online Video 2). Chest x-ray revealed multiple pellets (E), and the fluoroscopic image showed pellets moving consonant with cardiac motion (E and F, Online Video 3). The patient was discharged after an uneventful recovery from his non–ST-segment elevation myocardial infarction.
- Received October 17, 2013.
- Accepted November 5, 2013.
- American College of Cardiology Foundation