Bullet embolism to the heart secondary to gunshot wound of the left subclavian vein: A case report

Missile embolism as a consequence of gunshot wounds is a rare occurrence, and can lead to severe complications such as endocarditis, pulmonary thromboembolism and arrythmias. The correct diagnosis of bullet embolism can be challenging in an emergency care setting, often requiring a combination of clinical, radiological and surgical resources. The management of a venous missile embolism depends on characteristics such as size and location of the projectile, and must be highly individualized for each patient. In this report, a case of bullet embolism to the heart in a patient who suffered a gunshot wound to the left subclavian vein provides a backdrop for the discussion of the diagnosis and treatment of this rare ballistic injury. •Missile embolism is a rare complication of gunshot wounds, usually caused by small-caliber bullets.•Most cases of missile embolism involve veins, with the projectile eventually migrating to the right ventricle or the pulmonary artery.•A projectile migrating to the heart may cause severe complications, such as endocarditis, thrombosis, pneumonia and arrythmias.•Surgical intervention is recommended for the majority of intracardiac projectiles, particularly when they are >5mm.