Abstract:
INTRODUCTION:Firearm-related injuries account for 20% of all injury-related deaths and are responsible for 105,000 injuries annually. The occurrence of bullet emboli to the heart is exceedingly rare. Given the rarity of emboli, controversy exists over management. The primary endpoint of this study is to establish a management algorithm for venous bullet emboli to the heart. MATERIALS AND METHODS:A literature search was performed using PubMed and Google Scholar with the following search terms: cardiac bullet embolus, cardiac missile embolus, and bullet embolus. Any discoverable case report(s) or series after 1960 were included in the review. The following data points were collected: age, sex, presentation, imaging, foreign body entry site, foreign body destination site, management, and outcomes. RESULTS:Fifty-four articles met our search criteria. A total of 62 patients with thoracic venous bullet emboli were identified with the following distributions: right atrium (9.7%), right ventricle (54.8%), pulmonary arterial tree (32.3%), and intra-thoracic inferior vena cava (3.2%). Only 11.3% of patients had symptoms directly related to the cardiac venous emboli; however, all patients with acute symptoms underwent immediate intervention. Of those patients with bullet emboli to the pulmonary arterial tree, 45% were observed; whereas, only 20% with emboli to the right heart were observed. Those without signs or symptoms usually underwent an intervention (72.7%). Endovascular retrieval was successful in 53% of attempts. Of the endovascular attempts that failed, 28.6% were observed and 71.4% underwent open retrieval. Those who were asymptomatic and observed had no reported adverse sequelae during the follow-up. No mortalities were discovered in this review. CONCLUSION:Bullet emboli can prove to be a clinical challenge. Adjuncts such as X-ray, computed tomography, transthoracic, and/or transesophageal echocardiography help establish the emboli location. While observation in the asymptomatic patient is reasonable in some circumstances, most patients undergo removal. Removal of bullet cardiac emboli is safe with the availability of modern techniques.
journal_name
Mil Medjournal_title
Military medicineauthors
Yoon B,Grasso S,Hofmann LJdoi
10.1093/milmed/usx191subject
Has Abstractpub_date
2018-09-01 00:00:00pages
e307-e313issue
9-10eissn
0026-4075issn
1930-613Xpii
4962497journal_volume
183pub_type
杂志文章abstract::Deep water running (DWR) has become a well-recognized from of cardiovascular conditioning for injured athletes and has been used successfully to maintain running performance. DWR provides for decreased stress and weightbearing to injured tissue and joints, allows for maintenance of cardiovascular fitness and a trainin...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVES:Military medical subspecialists consult with referring physicians, direct patient care and education, support isolated subspecialists, and maintain cohesive readiness plans. The World Wide Web appears promising in fulfilling these roles. METHODS:A website providing directed resources, the Walter Reed Army M...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:INTRODUCTION:Over 5,300 inguinal hernia repairs (IHR) were performed in the Military Health System in 2015. Chronic pain can be a debilitating complication, occurring in up to 34% of patients after IHR and impacts mission readiness. Gabapentin has been shown to be effective for postoperative analgesia in a variety of o...
journal_title:Military medicine
pub_type: 杂志文章,随机对照试验
doi:10.7205/MILMED-D-17-00107
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:Combat deployment is associated with mental and physical health disorders and functional impairment. Mental health (MH) diagnoses such as adjustment and anxiety disorders have received little research attention but may reflect important postdeployment sequelae. The purpose of this study was to investigate ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa301
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abstract::The difficulty and importance of developing and implementing a definition of quality in health care is discussed. Some current definitions are considered, and a recommended definition of quality health care is presented. ...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract:INTRODUCTION:Dietary intake of military initial entry trainees is often inadequate because of the structured food environment, lack of snacking, and limited time for meals. Inadequate intake during training increases risk for injury, poor performance, and attrition from training. A performance nutrition initiative was ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-15-00451
更新日期:2017-01-01 00:00:00
abstract:INTRODUCTION:In 2017, over 75,000 cataract surgeries were performed within the Veterans Health Administration System (VHA). Previous reports of outcomes of cataract surgery in veterans include patients with pre-existing ocular disease, which can affect vision. To exclude the confounding factor of pre-existing ocular co...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy375
更新日期:2019-07-01 00:00:00
abstract::Military free fall or HALO (high altitude-low opening) is a distinct form of tactical parachuting used by the elite forces of the U.S. military. This study was undertaken to examine the type, location, and mechanism of injuries sustained by the military HALO parachutist during training. A retrospective study identifie...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1999-07-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-16-00096
更新日期:2017-03-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-17-00054
更新日期:2017-07-01 00:00:00
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journal_title:Military medicine
pub_type: 历史文章,杂志文章
doi:10.7205/milmed.170.3.183
更新日期:2005-03-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa308
更新日期:2021-01-25 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/MILMED-D-15-00232
更新日期:2016-03-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy213
更新日期:2018-11-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-16-00405
更新日期:2017-09-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa165
更新日期:2020-12-30 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-12-00249
更新日期:2012-12-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-15-00332
更新日期:2016-10-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1999-03-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa118
更新日期:2020-09-18 00:00:00
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journal_title:Military medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:Many people are unaware of the science underlying the biophysical properties of Soldier clothing and personal protective equipment, yet there is a well-refined biomedical methodology initiated by Army physiologists in World War II. This involves a methodical progression of systematic material testing technol...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-16-00156
更新日期:2017-07-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usz287
更新日期:2020-01-07 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/milmed.173.8.743
更新日期:2008-08-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2003-11-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usz276
更新日期:2020-03-02 00:00:00
abstract::Despite significant advances in hearing protection and compliance with protective standards, military personnel are still subject to noise-induced hearing loss in many combat and combat support operations. Although the Army has experienced a decrease of some 15% in primary hearing loss disability cases since 1986, a f...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2003-06-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2002-10-01 00:00:00