SUMMARY Stab wounds of the heart resulting in tamponade and interventricular septal defects may be readily diagnosed and successfully corrected. Because it is uncommon, an additional report appears warranted. In this case, cardiac tamponade was initially treated by pericardiocentesis and followed by surgical repair approximately 4½ hours after admission. About 3½ months later, the persistent ventricular septal defect was repaired with the aid of a pump oxygenator. The patient was last seen 13½ months after repair of the ventricular septal defect. There was no residual murmur or cardiomegaly. If cardiac tamponade is not relieved promptly by pericardiocentesis, repair of the ventricular wall is mandatory. Repair of the ventricular septal defect does not appear to be an urgent problem. A period of observation allows one to evaluate the hemodynamic significance of the left-to-right shunt, permits possible healing of small defects, and permits the wound edges to become fibrotic, thus contributing to a more secure closure when this is necessary.