The mortality rate of cardiac trauma is extremely high, and timely and correct diagnosis is very important. It should be emphasized that patients with cardiac trauma are in critical condition, and a large number of tests should never be done to clarify the diagnosis and delay the resuscitation of the patient. The medical history and signs are an important basis for deciding on emergency surgery. Cardiac trauma is divided into two categories: penetrating cardiac injury and closed cardiac injury. Penetrating heart injuries are most commonly caused by stab wounds in peacetime. It is a common cause of death in thoracic trauma, and most patients die soon after the injury. Prompt diagnosis and prompt surgical treatment after the injury is the key to patient survival. Rapid preoperative preparation, correct surgical approach, intraoperative operation, effective cardiopulmonary resuscitation, and avoidance of missed combined injuries can improve treatment outcome. Reduce the mortality rate. I. Heart contusion: Most of the heart is crushed and shocked by the impact of heavy objects or driving discs on the forehead or falling from a height, resulting in epicardial or endocardial hemorrhage, or even hemorrhage and necrosis in a large part of the myocardial layer. Treatment requires bed rest, ECG monitoring, and close observation of changes in the condition. Pay attention to anti-arrhythmia, prevention and control of heart failure and correction of hypoxemia, etc. Cardiac lacerations are mostly caused by sharp objects, bullets, shrapnel, etc. penetrating the chest wall and injuring the heart, and a few are seen as closed injuries from violent impact on the anterior chest; right ventricular rupture is the most common. Most rapid death due to severe blood loss and cardiac compression. Second, cardiac compression: acute circulatory failure syndrome caused by blood accumulation in the pericardial cavity or compression by mediastinal hematoma, manifested by symptoms such as stuffy pain in the precordial region, dyspnea, irritability, oliguria or anuria. The main signs are Beck’s triad: (1) elevated venous pressure; (2) decreased arterial pressure; (3) weak heartbeat and distant heart sounds. Most of the patients fail to receive effective diagnosis and treatment and die, and those who have the chance to go to the hospital are also in critical condition and change rapidly due to pericardial tamponade and hypotensive shock. Heart rupture should be operated immediately to save lives, while transfusing blood and replenishing fluids. Acute cardiac tamponade is often critical, so pericardial puncture can be performed first to relieve the pressure and buy time for the dissection surgery. Subxiphoid pericardial window drainage is a surgical method to temporarily relieve the pressure in the pericardial cavity, but the operation field is deep and the operation is difficult. The purpose of open heart surgery is to cut open the pericardium, remove the accumulated blood, and repair the heart or large vessel laceration.