Cardiac trauma most commonly occurs after a motor vehicle accident, after a high fall, or after a crushing injury. The force directly damages the heart due to the maximal distension of the ventricular chambers during diastole, the indirect force causes a sudden increase in cardiac preload from the vena cava and extremity veins. The deceleration mechanism (due to inertia) can tear the heart valves, myocardium, and coronary arteries.