Coronary embolization in bullet wounds: role of perioperative coronary angiography.

The management of patients presenting with signs of myocardial ischemia after a gunshot injury to the chest remains unclear. We report the case of 1 patient shot by a hunting weapon, presenting with clinical signs of tamponade and marked ST segment elevation. At the time of emergency exploration, no coronary lesions were seen. However, an emergency angiogram revealed acute occlusion of the right coronary artery by a pellet. Extraction was done on bypass. We believe that coronary angiography is necessary in case of pellet wounds to the chest presenting with signs of ischemia.