Shotgun pellet causes 'silent heart attack'

Between six and 200 pieces of birdshot are believed to be inside the man.
CORPUS CHRISTI, Texas (AP) -- The 78-year-old lawyer wounded by Vice President Dick Cheney in a hunting accident suffered a mild heart attack Tuesday after a shotgun pellet in his chest traveled to his heart, hospital officials said.
Harry Whittington was immediately moved back to the intensive care unit and will be watched for a week to make sure more of the metal pellets do not reach other vital organs. He was reported in stable condition.
Whittington suffered a "silent heart attack" -- obstructed blood flow, but without the classic heart-attack symptoms of pain and pressure, according to doctors at Christus Spohn Hospital Corpus Christi-Memorial.
The doctors said they decided to treat the situation conservatively and leave the pellet alone rather than operate to remove it. They said they are highly optimistic Whittington will recover and live a healthy life with the pellet in him.
Asked whether the pellet could move farther into his heart and become fatal, hospital officials said that was a hypothetical question they could not answer.
Hospital officials said they were not concerned about the six to 200 other pieces of birdshot that might still be lodged in Whittington's body. Cheney was using 71/2 shot from a 28-gauge shotgun. Shotgun pellets are typically made of steel or lead; the pellets in 71/2 shot are just under a tenth of an inch in diameter.
Cheney watched the news conference where doctors described Whittington's complications. Then the vice president called him, wished him well and asked if there was anything that he needed.
"The vice president said that he stood ready to assist. Mr. Whittington's spirits were good, but obviously his situation deserves the careful monitoring that his doctors are providing," the vice president's office said in a statement.
No comments
Cheney, an experienced hunter, has not spoken publicly about the accident, which took place Saturday night while the vice president was aiming for a quail. Critics of the Bush administration called for more answers from Cheney himself.
Whittington has said through hospital officials that he does not want to comment on the shooting. A young man at Whittington's Austin home who identified himself as his grandson said Tuesday he did not have time to talk to a reporter and closed the door.
The furor over the accident and the White House delay in making it public are "part of the secretive nature of this administration," said Senate Democratic Leader Harry Reid of Nevada. "I think it's time the American people heard from the vice president."
Before hospital officials announced details of Whittington's condition, the hunting accident had produced a raft of Cheney jokes on late-night television.
"I think Cheney is starting to lose it," Jay Leno said. "After he shot the guy, he screamed, 'Anyone else want to call domestic wiretapping illegal?!"'
On Tuesday morning, the White House spokesman briefly joined in the merriment, joking that the orange school colors of the visiting University of Texas championship football team should not be mistaken for hunters' safety gear.
"The orange that they're wearing is not because they're concerned that the vice president may be there," press secretary Scott McClellan said. "That's why I'm wearing it."
Likely causes
Hospital officials said they knew that Whittington had some birdshot near his heart and that there was a chance it could move closer since scar tissue had not had time to harden and hold the pellet in place.
After Whittington developed an irregular heartbeat, doctors performed a cardiac catheterization, in which a thin, flexible tube is inserted into the heart, to diagnose his condition, said Peter Banko, the administrator at the hospital.
The shot was either touching or embedded in the heart muscle near the top chambers, called the atria, officials said. Two things resulted:
*It caused inflammation that pushed on the heart in a way to temporarily block blood flow, what the doctors called a "silent heart attack." This is not a traditional heart attack where an artery is blocked. They said Whittington's arteries, in fact, were healthy.
*It irritated the atria, caused an irregular heartbeat known as atrial fibrillation, which is not immediately life-threatening.