Q: My friend, 32 years old, was caught in a bomb blast and a tiny metal particle got embedded (1.5 mm x 10 mm) into the muscle mass of his heart. He was operated upon but the surgeon did not take out the metal piece and only repaired the damage to the heart. The metal piece remains embedded in the muscle mass and the surgeon opines that it won't cause any harm. He has advised him to keep away from high magnetic fields and also not to undergo MRI scan ever in his life. What should we do now? Can this metal piece cause him any harm? Are there any other precaution he should take? Can he do exercises as any other normal person?

A:There is general consensus of medical opinion in leaving behind a small metal piece in the heart muscle rather than attempting to surgically remove it and leave behind a scar which has its own medical complications such as irregular heart rhythms and tendency for clot formation. Since most metallic pieces of bombs are ferromagnetic it would be advisable to keep away from MRI magnets. In the future, some MRI magnets may be able to handle patients with metallic pieces as well.