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Context: Penetrating trauma to the thoracic cavity can result in immediate or delayed injuries to the heart. These injuries include among others contusion of the cardiac muscle, and laceration of the coronary arteries resulting on ischemia. Although, nonoperative management is a tempting option on a stable patient; close monitoring is guaranteed after this type of injury regardless of the initial vital signs. Case report: We describe a case of a gunshot wound on a stable patient that was found to have blunt cardiac injury by the bullet. In the previous workup the missile appeared not to be penetrating the cardiac structures. Conclusion: Awareness of this rare injury may provide a more rapid diagnosis, thereby preventing potentially catastrophic outcomes.

Gunshot Wound to the Box: A Threat even on a Stable Patient