Medical Complications for Shooting Victim Whittington

Cardiologists described Harry Whittington's setback Tuesday as a silent heart attack. A shotgun pellet from last weekend's hunting accident traveled to his heart. Whittington's doctors have not specified what treatment they are administering.

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STEVE INSKEEP, host:

So, those are the politics of the shooting, and here's more on the condition of the shooting victim. Doctors describe his latest setback as a silent heart attack.

Here's NPR's Allison Aubrey.

ALLISON AUBREY, reporting:

Early yesterday morning, Harry Whittington was reportedly resting comfortably, experiencing no pain, when cardiologist in the Corpus Christi Hospital where he's being treated picked up an irregular heart beat. They ordered a series of diagnostic imaging tests, including an ultrasound and a CAT scan, and determined that one of the birdshot pellets that penetrated his body during the shooting accident had now moved to his heart.

Dr. DAVID BLANCHARD (Chief of Emergency Care, Corpus Christi Hospital): We knew that he had some birdshot very close to the heart from the get-go, but in point of fact, it is now got to the point where it has caused some inflammatory changes, and has moved into a position which has caused some irritability of the muscle of the heart.

AUBREY: That's Dr. David Blanchard, Chief of Emergency Care at the Corpus Christi hospital, speaking at a press conference yesterday. He says this muscle irritation has caused a condition known as atrial fibrillation.

Dr. BLANCHARD: It's a type of irregular heartbeat in which the upper chambers of the heart beat irregularly.

AUBREY: David Pearle, a Georgetown University cardiologist, says atrial fibrillation is usually not terribly dangerous or difficult to treat.

Dr. DAVID PEARLE (Cardiologist, Georgetown University): But there are some complications in this situation.

AUBREY: For example, if someone Harry Whittington's age has atrial fibrillation longer than 48 hours, the normal treatment would be to give blood thinners.

Dr. PEARLE: But blood thinners, in this case, might be very dangerous if he has a penetrating wound into the heart. So, there will be some issues about how the atrial fibrillation is managed if he doesn't, if the rhythm does not convert spontaneously, decisions will have to be made whether to bring him back to a normal rhythm, either with drugs or an electrical shock.

And in fact, some of those decisions may have already been made.

AUBREY: Whittington's doctors say the condition is easily treated with medicine, but they did not specify what treatment they're administering.

One concern, says David Pearle, is that doctors can't fully anticipate the range of complications, including an infection. Cardiologists treat millions of heart attacks a year, ones mostly caused by clogged arteries. But in this instance, tests show that Whittington's arteries were clear. His heart attack was caused by the lodging of the birdshot.

Dr. PEARLE: When you get a very unusual, traumatic injury like this, the range of possibilities is much less well understood, so I'm sure every attempt will be made to err on the side of being unusually cautious, because there are a lot of things that could emerge unexpectedly here.

AUBREY: Whittington's doctors decided against removing the birdshot pellet. They say the risk of open heart surgery is too great.

Cardiologist Stuart Seides, of the Washington Hospital Center, says what Whittington's doctors will look out for now is further movement of the birdshot.

Dr. STUART SEIDES (Cardiologist, Washington Hospital Center): Once the birdshot stays put, the human body will tend to try to wall it off and keep it immobile. In other words, it will be recognized as a foreign body, and the cells of the human body will then look to sort of isolate the birdshot from the rest of the body.

AUBREY: It could take the body several days to begin walling off the pellet, but Whittington's doctor, David Blanchard, says they're optimistic.

Dr. BLANCHARD: People do very well with shrapnel in their body. Some people can have some problems and difficulty, but certainly, that's why we're watching him in a close observation situation.

AUBREY: Blanchard says he expects Harry Whittington to remain in the hospital one more week.

Allison Aubrey, NPR News, Washington.

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