A patient is described in whom the diagnosis and location of a traumatic ventricular septal defect and laceration of a mitral leaflet were documented by two-dimensional echocardiographic studies. The echocardiographic study provides information not available from catheterization and contrast angiogram, and may be very valuable in subsequent patient management, as in this case. A patient is described in whom the diagnosis and location of a traumatic ventricular septal defect and laceration of a mitral leaflet were documented by two-dimensional echocardiographic studies. The echocardiographic study provides information not available from catheterization and contrast angiogram, and may be very valuable in subsequent patient management, as in this case.