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<p>Penetrating heart disease due to gunshot wounds is associated with high mortality rates, with the right ventricle being the most frequently affected cardiac region due to its anterior anatomical location. However, traumatic acute ventricular septal defects resulting from bullet lodging in the interventricular septum are quite rare. A 30-year-old female patient with no known underlying medical conditions presented to a secondary-level emergency department with hemodynamic instability following a gunshot wound. After intubation, she experienced cardiac arrest, but return of spontaneous circulation was achieved with brief cardiopulmonary resuscitation. Due to the lack of bedside ultrasonography, a contrast-enhanced thoracic computed tomography scan revealed a hemopericardium filled with a fractured sternum and a bullet lodged in the interventricular septum. The patient was urgently transferred to a tertiary center and underwent surgery under cardiopulmonary bypass. During surgery, the bullet was removed, and the fragmented traumatic ventricular septal defect was primarily repaired. The patient was discharged without sequelae, with no clinical complications detected during postoperative follow-ups. This case demonstrates that, despite a transport time of approximately 1.5&#xa0;h in penetrating cardiac injuries where resource constraints were considered, successful surgical outcomes can be achieved with appropriate resuscitation and timely referral to a specialized center.</p>

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Intracardiac Bullet in Young Woman Following Gunshot Wound

  • 期刊论文

  • 发表日期：

    2026年3月26日

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  • Mehmet Esat Ferhatlar,
  • Mehmet Yazar

摘要

Penetrating heart disease due to gunshot wounds is associated with high mortality rates, with the right ventricle being the most frequently affected cardiac region due to its anterior anatomical location. However, traumatic acute ventricular septal defects resulting from bullet lodging in the interventricular septum are quite rare. A 30-year-old female patient with no known underlying medical conditions presented to a secondary-level emergency department with hemodynamic instability following a gunshot wound. After intubation, she experienced cardiac arrest, but return of spontaneous circulation was achieved with brief cardiopulmonary resuscitation. Due to the lack of bedside ultrasonography, a contrast-enhanced thoracic computed tomography scan revealed a hemopericardium filled with a fractured sternum and a bullet lodged in the interventricular septum. The patient was urgently transferred to a tertiary center and underwent surgery under cardiopulmonary bypass. During surgery, the bullet was removed, and the fragmented traumatic ventricular septal defect was primarily repaired. The patient was discharged without sequelae, with no clinical complications detected during postoperative follow-ups. This case demonstrates that, despite a transport time of approximately 1.5 h in penetrating cardiac injuries where resource constraints were considered, successful surgical outcomes can be achieved with appropriate resuscitation and timely referral to a specialized center.