A case report: A man creates holes in his own heart.

We report a rare case of a 59-year-old male with a history of depression stabbed himself from xiphoid to heart. Following initial cardiothoracic surgery for hemothorax and cardiac repair, the patient was discharged and transferred to a psychiatric facility for depression treatment. Four weeks later, he returned with complaints of chest pain, cough, and expectoration. Further examination found abnormal blood pathways in heart and second surgery confirmed these were attribute to the original penetrating injury. This case highlights the delayed complications of penetrating cardiac trauma and underscores the importance of multidisciplinary management in such complex scenarios.