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Symptoms of little particles reaching MYOCARDIUM from ENDOCARDIUM.

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Dear sir.
I almost understand my assumption is very hard. Because i learned that there is no capillaries in endocardium. It is located in sub and myocardium. So it is very hard to bleed continuously.
Now I have one assumption.
Pls. Teach me it is possible or not.
Little particle stuck in the layer and after time flow, because of the blood pressure, that particle move inside slowly and slowly and finally reach myocardium.(as far as I know thickness of endorcardium of right ventricle is 2mm?)
Question is
If particle(2-3mm)stuck not firmly and move slowly inside, can we know symptom? Or after reaching the myocardium and then we could know? (It has nerve and vessel)
Or impossible pls. Teach me why it could not get inside with the help of blood velocity and heart pumping. as far as I know, the velocity of blood from right atrium to ventricle is very fast..
Or could know easily when particle move inside very slowly by inflammation or big clot or something big problem h

Pls. Explain me

Category: Infectious Disease Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thank you for your query at DoctorSpring.com
Okay let's assume the particle somehow reaches the heart and enters the myocardium. But for that to happen it has to avoid all inflammatory cells that are ready to engulf it. But assuming it reaches the myocardium, it is possible that it will just be circulated back as it can't really lodge anywhere in the heart.
In all likelihood, if it miraculously reaches heart, it will be engulfed and there will be clot inside the heart. But also this will lead on to symptoms. Actually any foreign body wherever it enters, it will immediately be blocked and you will feel local swelling. However if it does reach heart because of velocity it will form an embolus, and in such cases can be dangerous if the clot is dislodged.

Patient replied :

Thank you for your answer. May I ask this query. If I know macrophage surely works for wood sprinter such like engulf or eating or etc..., I don't need to make imagination for particle getting stuck in endocardium. If it works, it would be coverd by clot before reaching the heart... I know macrophage and immune system works well for virus... but I am not sure immune system also works for wood spinters... is there any medical data or experimental data? or it is doctor's assumption? Sometimes we heard that broken needle stuck in the vein or heart... that means immune system don't works for that... and broken glass ampule get into vein and without disturbing... they also could flow to heart or other organ.. is there any evidence for macrophage works for wood particle... this is really curous query... Thank you

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

No there is no such medical evidence.
However there has been such injuries before, and I have never heard of such wood or other particle flowing all the way to the heart.
So all I can tell you, is your thinking is really smart and definitely the questions arise out of curiosity, but it is not possible. Wherever the particle enters it will stay there and cause a local swelling.

Patient replied :

Dear Sir.
Thank you very much.
If sharp particle stuck in the endocardium, inflammatory cells engulf the the edge and cover the sharp egde... So, it is very hard to move inside to mycardium. Stucking there... right?

Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Yes it does not move into myocardium like that.
Also if a sharp particle goes inside before it reaches heart, there will be lots of hurdles it has to overcome. It will produce local symptoms through wherever it goes in, necessitating prompt treatment.

Patient replied :

Thank you sir.
I almost understand that what I image is not so easilly happen and very hard to be happen.
Thanks for giving me advice.
Last query that I want to know is what if....(I know it is very hard to happen)
particle stuck and move and prick the myocardium very little (1mm)... in my point of veiw, people cannot die becuase of that event... myocardium engulf the particle. nothing happen...
What do you think.. people is going to die for that event?
Thank you very much.

Expert:  Dr. Deepu Sebin Sebastian replied 1 Day.

No such a thing has never been recorded. So people can't die of such an event.
Also it will pass on to systemic circulation and not stay at myocardium.

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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