In cardiac trauma the two main mechanisms of injury are blunt and penetrating trauma. Common cardiac effects of trauma include myocardial rupture, contusion, laceration, pericardial insult, coronary injury, valvular damage, arrhythmias, and conduction abnormalities. Hemodynamic instability can develop rapidly and pose marked risk to patient survival. An adequate level of clinical awareness and timely use of diagnostic techniques such as echocardiography, aortography, and cardiac angiography are essential for rapid identification of cardiac trauma. Once the diagnosis is made, prompt surgical intervention is often the key to survival.