Should lead levels be monitored if a bullet is lodged near heart?
Yes, lead levels need to be monitored
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Yes lead levels need to be monitored as there is a possibility of lead intoxication from retained bullets over long term. Abdominal colicky pain, unexplained anemia, neurological symptoms/deterioration and renal dysfunction are common signs and symptoms that can be related to such delayed complications i.e after a period of 10 to 15 years.
Late complications may also include embolization of the projectile, endocarditis and pericarditis depending upon the exact location of the bullet. Computed tomography, angiocardiography and transesophageal echocardiography are useful in exactly locating the projectile. Asymptomatic patients would not require intervention if the bullet is completely embedded and no adverse effects have appeared till date.
Wishing you best of health
Please consult your doctor before deciding on any further course of action.
Dr. M.S. Khalil
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