Although the editors of this site not are not providing care to Harry Whittington, who was shot by Vice-President Dick Cheney on February 12, 2006, there appear to be some puzzling questions that remain unanswered about what happened to the patient after he was taken to the hospital.
Birdshot wounds are a common hunting injury seen by trauma surgeons. The injury is caused by
multiple small metal pellets striking the patient in a spray pattern. The closer the victim is to the shooter, the more dangerous and life-threatening the injury. As the distance from the fired gun increases, the lethality of any one pellet diminishes as the velocity of pellet falls as it travels through the air.
At any distance, however, the pellets can cause trouble depending on what they hit. For instance, a pellet that impacts the eye can cause loss of the eye. A pellet that enters any muscle, as the heart is, can cause local damage.
The damage reported by the doctors in Texas stated that the victim suffered an irregular heart beat known as atrial fibrillation. This is a common arrhythmia in hospitalized patients, especially older patients. It can be caused by a myriad of things including fluid overload, electrolyte imbalance, stress, and local damage to the muscle.
In atrial fibrillation, the top chambers of the heart called the atria do not beat in a regular fashion and in conjunction with the bottom chambers or the ventricles. Because the ventricles have lost their normal stimulus from the atria, they may beat at near normal rate or at an extremely high rate. This is called a supraventricular tachycardia or rapid rate atrial fibrillation. If rapid rate atrial fibrillation occurs it can cause a dangerously low blood pressure or hypotension, inadequate pumping of blood to the heart muscle itself, dizziness, or loss of consciousness.
The treatment of rapid rate atrial fibrillation if there is hypotension or any of the above conditions is an immediate shock to the heart called electrical cardioversion. If the rate is high but there are no symptoms or if the rate is slow, patients are given medication to either slow the rate of the heart or slow it and also convert the heart rate back to a normal rate called sinus rhythm. This is most typically done by drugs called beta blockers, calcium channel blockers, or the drug amiodarone.
What is unusual in this situation is that most atrial fibrillation is not associated with a heart attack or myocardial infarction and most patients with atrial fibrillation do not receive an emergent cardiac catheterization for new onset atrial fibrillation alone. This would most typically only occur if there were signs of death of heart muscle through a blood test for substances called troponins or substances called CK MB, an abnormal electrocardiogram or ECG (EKG), or an abnormal echocardiogram. The doctors in Texas are not reporting that any of these tests were performed or were abnormal.
Copyright 2006 Surgeryandyou.com
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