Based on Parreira & Coimbra, J Trauma Acute Care Surg 2025 ('What You Need to Know')
Precordial stab wounds and mediastinal/thoracic gunshot wounds. The "cardiac box" (sternal notch to xiphoid, between the mid-axillary lines) carries a higher risk (13.0% vs 2.6% cardiac injury), but GSWs often injure the heart from wounds outside the box. GSW is the most common mechanism (58%) but survival is far lower than stab wounds (9% vs 33%).