The victims ranged in age from 9 weeks to 2.5 years. Five of the six victims were females. Five cases involved lacerations of the right ventricle; the other involved laceration of the left ventricle. In the three cases with a confession, one victim each was struck with a fist, stomped, and kicked. Four victims had rib fractures, with at least two fractures each. The analysis revealed that cardiac rupture from blunt trauma most commonly results from compression of the heart between the sternum and vertebral column, but may also occur from compression of the abdomen or legs, deceleration, blast injury, puncture of the heart by a fractured rib, and rupture through a resolving contusion. Accidentally acquired cardiac lacerations usually result from traffic accidents or similarly severe forces. In children, no well documented cases exist in which cardiopulmonary resuscitation has resulted in cardiac laceration or rib fractures. Cardiac lacerations, as with other types of severe trauma acquired at home, are almost never accidental. Photographs, table, and 29 references