Double Dare Leads to Cardiac Scare

Remember, pointing a pellet gun at your boyfriend's chest and pulling the trigger, even when he dares you to, may not be the smartest thing to do. Fortunately for this guy, he was saved by extensive right coronary artery collaterals and a very capable surgeon:

“He is a miracle case because so many things went in his favor,” said Dr. Nicholas Namias, Jackson Ryder Trauma department director and one of the surgeons who operated on him last week.

Most miraculous was the rare anatomy of Mendigutia’s heart. The bullet caused a blockage in the left anterior descending artery, the heart’s main artery. But because of his heart’s “very rare” anatomy, blood was able to flow through the opposite side of the artery.

Also, in this type of case, the pellet could have affected his aorta, esophagus and/or trachea, said Namias. In this case, it missed all three.

Mendigutia was airlifted to Ryder Trauma at midnight May 23 with cardiac tamponade, which means blood was filling up in the space between the myocardium (heart muscle) and pericardium (outer covering the heart). This prevents the ventricles from expanding and can cause a heart attack.

“Gabriel had a right coronary artery that supplies the left anterior descending distribution. He had a blockage, but rare anatomy allowed blood to flow backwards to area of injury, “said Namias, who doubts any other area hospital would have been able to save his life.

-Wes

Addendum 6 June 2011: The man's post-op picture and follow-up story here.