Version June 2024
| Grade* | Description of injury |
| I | Blunt cardiac injury with minor ECG abnormality (nonspecific ST or T wave changes, premature atrial or ventricular contraction, or persistent sinus tachycardia) |
| Blunt or penetrating pericardial wound without cardiac injury, cardiac tamponade, or cardiac herniation | |
| II | Blunt cardiac injury with heart block or ischemic changes without cardiac failure |
| Penetrating tangential cardiac wound up to but not extending through endocardium, without tamponade | |
| III | Blunt cardiac injury with sustained or multifocal ventricular contractions |
| Blunt or penetrating cardiac injury with septal rupture, pulmonary or tricuspid incompetence, papillary muscle dysfunction, or distal coronary artery occlusion without cardiac failure | |
| Blunt pericardial laceration with cardiac herniation | |
| Blunt cardiac injury with cardiac failure | |
| Penetrating tangential myocardial wound up to but not through endocardium, with tamponade | |
| IV | Blunt or penetrating cardiac injury with septal rupture, pulmonary or tricuspid incompetence, papillary muscle dysfunction, or distal coronary artery occlusion producing cardiac failure |
| Blunt or penetrating cardiac injury with aortic or mitral incompetence | |
| Blunt or penetrating cardiac injury of the right ventricle, right or left atrium | |
| V | Blunt or penetrating cardiac injury with proximal coronary artery occlusion |
| Blunt or penetrating left ventricular perforation | |
| Stellate injuries <50% tissue loss of the right ventricle, right or left atrium | |
| VI | Blunt avulsion of the heart |
| Penetrating wound producing >50% tissue loss of a chamber |
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