Table 1 Cardiac injury grading according to OIS-ASST system (see reference [17])

I

Blunt cardiac injury with minor ECG abnormality (non-specific ST or T wave changes, premature atrial and 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 (right or left bundle branch, left anterior fasicular or atrioventricular) or ischemic changes (ST depression or T wave inversion) without cardiac failure.

Penetrating tangential myocardial wound up to but not extending through the endocardium, without tamponade.

III

Blunt cardiac injury with sustained (≥5 beats/min) or multifocal ventricular contractions.

Blunt or penetrating cardiac injury with septal rupture, pulmonary or tricuspid valvular incompetence, papillary muscle dysfunction, or distal coronary arterial occlusion without cardiac failure.

Blunt pericardial laceration with cardiac herniation.

Blunt cardiac injury with cardiac failure.

Penetrating tangential myocardial wound up to but not extending through the endocardium, with tamponade.

IV

Blunt or penetrating cardiac injury with septal rupture, pulmonary or tricuspid valvular incompetence, papillary muscle dysfunction, or distal coronary arterial occlusion producing cardiac failure.

Blunt or penetrating cardiac injury with aortic or mitral valve incompetence

Blunt or penetrating cardiac injury of the right ventricle, right atrium, or left atrium

V

Blunt or penetrating cardiac injury with proximal coronary arterial occlusion

Blunt or penetrating left ventricular perforation

Stellate injuries <50% tissue loss of the right ventricle, right atrium, or left atrium

VI

Blunt avulsion of the heart: penetrating wound producing >50% tissue loss of a chamber