Shrapnel wound of the heart with benign manifestations: Involvement of the diaphragmatic surface of the heart with pain referred to the shoulder and neck

Abstract

1. 1. A case is presented of a soldier who had a shrapnel wound of the heart and was asymptomatic except for referred pain in the left shoulder and neck region. 2. 2. The foreign body was accurately localized and successfully removed at operation. It consisted of a piece of shrapnel 7 × 7 × 8 mm. which was embedded in the musculature of the diaphragmatic surface of the right ventricle. 3. 3. Foreign bodies of the heart may be asymptomatic and, unless adjacent structures such as the diaphragmatic pleura are involved, no symptoms need arise. 4. 4. The patient was carefully studied less than a year after being wounded and six months after the operation. He was found to be in excellent health and, except for some interesting electrocardiographic changes, there was no objective evidence of cardiac impairment.