Penetrating injuries to the “cardiac box“ are amongst the most lethal traumatic injuries with an estimated 6% of the patients arriving to the hospital alive ADDIN EN.CITE <EndNote><Cite><Author>Mandal</Author><Year>2001</Year><RecNum>378</RecNum><DisplayText><style face="superscript">1</style></DisplayText><record><rec–number>378</rec–number><foreign–keys><key app="EN" db–id="0zr0929znp09x9eexd55rx9rv0szfsxe9dez">378</key></foreign–keys><ref–type name="Journal Article">17</ref–type><contributors><authors><author>Mandal, A. K.</author><author>Sanusi, M.</author></authors></contributors><auth–address>Department of Surgery, Charles R. Drew University of Medicine and Science, 1731 East 120th St., Los Angeles, California 90059, USA.</auth–address><titles><title>Penetrating chest wounds: 24 years experience</title><secondary–title>World J Surg</secondary–title></titles><periodical><full–title>World J Surg</full–title></periodical><pages>1145–9</pages><volume>25</volume><number>9</number><edition>2001/09/27</edition><keywords><keyword>Abdominal Injuries/ mortality/ surgery</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Female</keyword><keyword>Hemoptysis/etiology/mortality/therapy</keyword><keyword>Hospitals, Urban</keyword><keyword>Humans</keyword><keyword>Laparotomy</keyword><keyword>Longitudinal Studies</keyword><keyword>Los Angeles</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Survival Rate</keyword><keyword>Thoracic Injuries/ mortality/ surgery</keyword><keyword>Thoracotomy</keyword><keyword>Time Factors</keyword><keyword>Trauma Centers</keyword><keyword>Treatment Outcome</keyword><keyword>Wounds, Gunshot/complications/ mortality/ surgery</keyword><keyword>Wounds, Stab/complications/ mortality/ surgery</keyword></keywords><dates><year>2001</year><pub–dates><date>Sep</date></pub–dates></dates><isbn>0364–2313 (Print)&#xD;0364–2313 (Linking)</isbn><accession–num>11571950</accession–num><urls></urls><remote–database–provider>NLM</remote–database–provider><language>eng</language></record></Cite></EndNote>1. We report the benign presentation of a 79 year–old female with penetrating injury to the cardiac box. Post–operative course was unremarkable. In this report, we discuss the surgical implications of penetrating injury to the cardiac box.