Self-inflicted gunshot wound to the right coronary artery in a pediatric patient resulting in sternotomy and coronary artery stenting

Penetrating gunshot wounds to the heart are rare in children but can lead to severe complications requiring urgent intervention. This report describes a case of a 14-year-old male who sustained a gunshot wound to the anterior chest from a high-velocity pellet rifle, resulting in hemopericardium, cardiac tamponade, and potential injury to the right coronary artery. Following emergency surgery and the successful evacuation of a clot containing the pellet, the patient experienced ventricular fibrillation and was subsequently taken for percutaneous coronary intervention due to a middle right coronary arterial occlusion. Two drug-eluting stents were placed, restoring blood flow to distal vessels. Postoperatively, the patient was managed with antiplatelet therapy, including ticagrelor and aspirin. The case highlights the successful use of cardiac catheterization in a pediatric trauma patient and underscores the need for further research on optimal antiplatelet therapy in this population to prevent complications such as restenosis and stent thrombosis.