Fifty years ago, nearly all significant cardiac injuries were fatal, many were untreatable, and most undiagnosed until the autopsy suite. In the last 20 years, however, dramatic improvements in prehospital trauma management, new diagnostic modalities, and the availability of cardiac surgery in many hospitals have rendered treatable most cardiac injuries. Knowledge of various types of cardiac injuries, the methods available to facilitate rapid diagnosis, and familiarity with techniques for surgical repair are no longer an academic exercise but a life-saving necessity.