Commonly present with asymmetric peripheral pulses, evidence of metallic fragments remote from the site of penetrating injury (outside of the expected fragment trajectory), and lack of an exit wound .
However, patient presentation can vary. Hemodynamically stable vital signs, lack of penetrating trauma on a pulseless extremity, and the presence of an exit wound should not be used to exclude the diagnosis.
As delayed and occult arterial injury have been reported in the literature, serial imaging may be necessary if suspicion remains high in the absence of initial findings.
Distal ischemia
Thrombosis
Further embolization
Pulmonary artery<unk> m
Cardiac valve dysfunction
Endocarditis
Abscess formation
Sepsis
Thrombosis
Dysrhythmias
Intraventricular communications
Conduction defects
Tissue erosion
Hemorrhage
Cardiac ischemia from erosion into coronary vessels
Thrombophlebitis
Anxiety
Cardiac neurosis
Fear of movement resulting in a dislodgment of the missile from its current location
Missile embolus
Missile embolism
Coronary artery dissection
Acute arterial ischemia
Myocardial rupture
Arterial gas embolism
Subclavian steal syndrome
Vertebral and carotid artery dissection