Complex gunshot injury to the heart as a consequence of suicide attempt in a schizophrenic patient.

•Self- inflicted gunshot injury to the heart is uncommon in Western Europe.•Up to 40% of schizophrenic patients have history of suicide attempt.•Discontinuation of antipsychotic medications is one of the major risk factor for suicide among individuals with schizophrenia.•Midline sternotomy provides superior access to the heart and large vessels, pulmonary hilum as well as for access for extracorporeal circulation.