By a Hair’s Breadth
A 57-year-old man was admitted with chronic angina and an inferolateral ischemia documented by myocardial perfusion single-photon emission computed tomography. Coronary angiography revealed a subtotal occlusion of the first obtuse marginal branch (Figure 1) that was subsequently treated with a drug-eluting stent (Figure 2). During angiography, a radiopaque structure adjacent to the right coronary artery on the level of the crux cordis was detected (Figure 3). Intravascular ultrasound revealed a roundish structure with a diameter of 2.4 mm protruding in the lumen of the artery (Figure 4). On inquiry, the patient revealed a hunting accident 40 years ago when he was inadvertently hit by a buckshot charge in the chest while hunting small game in the mountains. At that time, there were only some minor cutaneous lesions that were treated conservatively. After the intervention, the patient was discharged home and remains free of symptoms.
- © 2013 American Heart Association, Inc.