This study presents a spectrum of injuries to the heart in 61 individuals from 2 months to 30 years of age who were in automobile accidents. Three patients are presented in detail. One patient died and had severe damage to the left ventricular myocardium. Another patient had severe damage to the tricuspid valve and survived after successful implantation of a Starr-Edwards valve. The third patient had a residual calcified plaque at the base of the left ventricle which was detected 30 years after a childhood automobile accident. Electrocardiographic changes compatible with myocardial injury were found in 29.5 per cent, and 19.6 per cent were found to have suspicious changes. Since the advent of open heart surgery, patients who sustain myocardial tears or rupture of cardiac septa are now potentially curable.