Nonsurgical management of cardiac missiles.

Modern air-powered pellet guns are capable of propelling their projectiles at velocities of 250 to 930 ft/s depending on their propulsion system-rivaling traditional small caliber firearms in the potential for serious soft tissue injuries. Management decisions regarding thoracic/cardiac pellet gun injuries must be based on the presentation and stability of the patient and the location of the retained pellet. We present a report of the nonsurgical management of an 8-year-old girl with a retained pericardial pellet and small stable effusion.