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A 68 year old man presented in 1992 with syncope related to complete heart block. A chest radiograph showed a small calibre bullet that appeared to be within the heart. A permanent pacemaker was implanted.
He had fought on the Russian front during the second world war, where he was wounded on five occasions. On the last of these he sustained a bullet wound to the left side of his neck below the angle of the jaw that healed, although the bullet was not recovered.
Chest radiographs recorded in 2003 (59 years after he was wounded) show the pacing electrode (*) and the bullet, which echocardiography showed was within the cavity of the right ventricle.