Posted on 02/15/2006 1:17:57 AM PST by neverdem
AP SCIENCE WRITER
WASHINGTON -- Despite the heart problem of the man wounded by Vice President Dick Cheney, doctors say removing the shotgun pellet from his chest probably won't be necessary - and digging it out could do more harm than good.
It's not unusual to live with shrapnel or other foreign objects in the body, even the heart, and specialists said it's likely the pellet will scar over rapidly without causing further problems for Texas lawyer Harry Whittington.
Hospital officials in Corpus Christi announced Tuesday that Whittington had suffered a "minor heart attack" and was returned to the intensive care unit.
It wasn't a traditional heart attack - no artery was blocked. In fact, the 78-year-old Whittington's doctors called his arteries healthy, and he felt no pain or other symptoms.
What apparently happened: Doctors noticed an irregular heartbeat Tuesday morning and took Whittington in for an exam called a cardiac catheterization, threading a wire up from the groin to see an image of exactly what was going on inside his heart.
One of the pellets from the 28-guage shotgun that Cheney had fired had migrated to the heart, either touching or embedding into the heart muscle near its top chambers, called the atria. That irritated those chambers to cause the irregular heartbeat known as atrial fibrillation.
But doctors also spotted inflammation - which always occurs when something foreign invades the body - that was causing a temporary block in blood flow, by touching or pushing the heart, explained Dr. David Blanchard, chief of emergency care at Christus Spohn Hospital Corpus Christi-Memorial.
That's what he termed a "silent heart attack."
A pellet striking the heart can cause those problems, but it's not normally thought of as a heart attack, said Dr. Samin Sharma, chief of interventional cardiology at New York's Mt. Sinai Medical Center.
"What probably happened is the pellet hit the heart and the heart released some enzymes" associated with a heart attack, he said. "It usually has a very good prognosis. ... It's not as significant as a heart attack."
Anti-inflammatory drugs will soothe the inflammation, and the pellet should scar over in time, he said.
Digging it out could cause more damage, specialists agreed.
Removal probably would be necessary only if the pellet had penetrated a heart chamber, something Whittington's doctors said didn't happen, added Dr. Soumitra Eachempati, a trauma surgeon at New York Presbyterian/Weil Cornell Hospital.
As for the atrial fibrillation, it's not immediately dangerous but must be treated because if left uncontrolled, it can spur blood clots. Most cases can be corrected with medication. Hospital officials didn't say Tuesday whether Whittington's heart was beating normally again, or if he was being medicated.
Until Tuesday's complications, physicians had said Whittington had been progressing well after being struck by birdshot in Saturday's hunting incident - and that they were not concerned about the six to 200 pieces of birdshot that might still be lodged in his body.
Whittington was about 30 yards away from Cheney when shot.
"At this distance he's peppered with lot of small holes," said Dr. J. Wayne Meredith of the Wake Forest School of Medicine, who has seen similar injuries.
A report filed with Texas Parks and Wildlife said the vice president was using size 7 1/2 shot. A three-quarter ounce load of that size shot would normally contain more than 250 pellets. Each pellet is about the size of a small letter "o" in newspaper print.
Birdshot is usually made with steel or lead, but even lead pellets left in the body wouldn't pose a danger of lead poisoning, said Dr. Renae Stafford, a trauma surgeon at the University of North Carolina, Chapel Hill, School of Medicine.
"People speak of lead poisoning, but in reality it's not something we see," agreed Dr. Maurizio A. Miglietta of the New York University School of Medicine.
AP Medical Writer Lauran Neergaard contributed to this report.
Just thinking about that procedure is likely to cause ME a heart attack.
I suppose I'm being rather picky, but this doesn't seem to be a true heart attack in the usual sense. There is no clotting and it is unlikely that tissue will die thereby impairing the heart's function long term.
It's almost as if... dare I say it... even the mention of 'heart attack' is more or less a trumped up term used in order to cause Cheney more grief.
You are evil. Just..... evil...
I wonder if the guy can brag...
Development and Validation of a Prognostic Index for 4-Year Mortality in Older Adults
FReepmail me if you want on or off my health and science ping list.
Just thinking about that procedure is likely to cause ME a heart attack.
We do a fair number of them everyday at the hospital that I work at, mostly on outstate cases that come in via helicopter.
Heh. A while back at a meeting to see if we could speed the process of getting the patients down from the helipad, into the CV lab, and catheterized. When you're having a heart attack, seconds count. One of the doctors suggested that the process might go more quickly if the fligh crews shave the groin of the patients while they were still in flight. The flight nurse who was present said that it would be like, "trying to shave on a tilt-a-whirl with one hand tied behind your back".
I wish he would run. Usually the VP runs the following term. I don't think he wants to run.
The dems absolutely cannot stand Mr. Cheney.
Not that uncommon....
""According to William Dellenback, the institute's photographer, Kinsey was becoming overtly exhibitionist-to the point of having himself filmed, always from the chest down, while engaged in masochistic masturbation. The world's foremost expert on sexual behavior would insert an object such as a pipe cleaner or swizzle stick into his urethra, tie a rope around his scrotum and then tug hard on the rope... "
http://www.duj.com/Article/chang-1t.jpg"
Figure 1: Abdominal-pelvic radiograph with the foreign body spanning the bulbar urethra, prostatic urethra, and the bladder neck. Arrows denote the location of the pen.
I'm evil? Read #12. THAT is evil.
A 3/4 oz field load figures out to 260 shot. If he caught anywhere near a full load, he was really close.
"Whittington was about 30 yards away from Cheney when shot."
Whittington's X-rays will be someone's fortune.
Kinsey was one strange bird, that's for sure. And his studies have basically been shot to hell because his statistics were so flawed it's laughable.
At the same time, I think he deserves credit for opening up the awareness of the public that some of the things they thought they should be ashamed of were, in fact, not all that unusual.
But the only way I'd stick a paper clip in a weiner is if it's Oscar Meyer! And not attached!
hehehe. I've had this procedure done several times and the procedure itself is not that bad. The part I hate comes afterward. They put a big clamp on you to stop the bleeding and you have to lie still on your back for hours.
I'm talking tip of yur pencil small. A dull pencil but still the tip.
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