In developed countries, cardiac trauma represents one of the leading causes of death in those under the age of 40 years. Non-penetrating cardiac trauma usually occurs following the application of direct external physical forces to the chest wall. Cardiac contusion is considered the most common injury to the heart following blunt trauma. Cardiac contusion usually produces no significant symptoms and can easily go unrecognized. Complications such as haemopericardium and tamponade can occur. In the case of cardiac herniation, the heartbecomes entrapped, there may be impaired filling and occasionally compression of the coronary arteries. Penetrating cardiac trauma is increasingly common with the majority being caused by gunshot and stab wounds, although shrapnel, fractured ribs, intracardiac diagnostic and therapeutic catheters can also produce penetrating cardiac injury. Patients who fail to respond to resuscitation and suddenly decompensate, should undergo immediate thoracotomy and repair of any treatable cardiac trauma.