Gunshot injury of the heart - An unusual cause of acute myocardial infarction

A 30-year-old man had multiple pellet injuries after being shot. An asymptomatic, acute, inferior-wall myocardial infarction was detected on an electrocardiogram at the time of a pre-anesthetic evaluation for eye surgery. A computed tomographic scan of the chest confirmed the presence of an intracardiac foreign body. Coronary angiography showed occlusion of the distal right coronary artery by a pellet. The patient was managed conservatively with aspirin and metoprolol. In conclusion, a single coronary lesion, the absence of other cardiac complications, and a favorable outcome with conservative medical treatment after a gunshot injury contribute to the rarity of this case of myocardial infarction.