A 33-year-old man presented to the emergency department with a 24-hour history of chest pain and dyspnea after an accidental penetrating chest trauma while working in construction. He lived in a rural area. He had no known medical history. His heart rate was 113 beats per minute, blood pressure 106/64 mmHg, respiratory rate 24 breaths per minute, and oxygen saturation was 89%. On physical examination, he appeared well, had a left parasternal wound without active bleeding, and a decreased breath sound in the left lung field, without jugular ingurgitation. A contrasted computed tomography (CT) was requested (Figures 1 and 2). Traumatic intraventricular foreign body. CT revealed a linear structure with metallic density across the fourth costal arc and his left ventricle, associated with pericardial effusion and left hemothorax. An emergency sternotomy was performed, and findings confirmed an injury of 1 cm diameter by a screw on the left ventricle, without coronary injuries; additionally, he required left thoracostomy, and pericardial and mediastinal drainage. Echocardiography 12 hours later informed a normal ventricular function without a segmentary defect, pericardial effusion, or valvular damage. Clinicians should have a high index of suspicion of a life-threatening condition, even if the injury is due to a low-energy trauma. At 4 days follow-up hospitalization without complications, the patient was discharged in good condition. Penetrating chest trauma is a surgical emergency, with a high risk of complications and death.1 Low energy injuries occurring due to non-explosive objects are a rare event.2 Multidetector CT may be essential to confirm the diagnosis and specify the location and additional findings that allow defining the most appropriate treatment.3 The authors received no financial support for the research, authorship, or publication of this article.