Introduction
Nail guns had been widely used in the industrial field due to the
effectiveness and time saving properties [1], but the lack of proper
training resulted in numerous body injuries mainly in peripheries
[2]. However, heart related nail gun injuries are rare and mostly to
the right chambers of the heart [3]. The majority of cases ended up
with good outcomes despite their acute presentations to the ED. This
favorable prognosis is mainly attributed to the presence of experts who
will guide the management approach starting from the preoperative
imaging and surgical intervention. We present a rare case of a chronic
nail gun injury to the left ventricle with formation of
coronary-pulmonary artery fistula.