Two-dimensional and color Doppler echocardiographic diagnosis of penetrating missile wounds of the heart: chronic complications from intracardiac course of a bullet.

Two-dimensional echocardiography has gained a role in the management of the acute complications of penetrating cardiac trauma and in precisely localizing retained bullet fragments within the heart. We report the case of an 8-year-old boy with chronic symptoms after a bullet wound. In this case, traumatic mitral regurgitation caused by mitral leaflet perforation and retention of the bullet in the tricuspid annulus occurred because of an unusual intracardiac course of the projectile. The diagnosis was made by transthoracic echocardiography. The ability of two-dimensional echocardiography to delineate the true location of the foreign body within the heart and Doppler ultrasound to identify mitral valve perforation helped guide a prompt, efficient, and successful surgical procedure.