Sir.—Penetrating cardiac injuries from gunshots are an all-too-frequent cause of morbidity and mortality in children.1,2 Trauma resulting from bullets and shell fragments has been well described.3-5 Cardiac injuries caused by BB and pellet guns have raised major concerns over their use.1,2,6 We describe a child in whom the air gun pellet, after left—ventricular-wall entry, lodged in the myocardium in close proximity to the posterior descending coronary artery. The patient remained asymptomatic and the pellet was removed successfully after localization by roentgenography, fluoroscopy, and echocardiography.
Patient Report.—An 11-year-old boy was "accidentally" shot by a friend with an air rifle fired at the left side of the patient's chest from a distance of about 90 cm. On admission, his blood pressure was 113/64 mm Hg, pulse rate was 95 beats per minute and regular, and respiratory rate was 24 breaths per minute. He was in no distress