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Penetrative cardiac injury can often result in life-threatening sequelae such as myocardial contusion or rupture, coronary vessel and valvular damage, pericardial effusion with tamponade, and arrhythmias of which gunshot injury is a chief culprit. We report a case of a suspected acute coronary syndrome after a cardiac gunshot injury that was conservatively managed.

“Shot to the Heart”: Case Report and Concise Review of Cardiac Gunshot Injury