A 31-year-old male patient comes to the ER after being stabbed in the third intercostal space. He was awake, alert and oriented, hemodynamically stable and had a thoracic drain. After ruling out the commitment of any other structure, he was discharged. After 2 months, was again admitted to the ER complaining of acute dyspnea, abdominal distension and pitting edema in lower limbs (++/4+). At the exam, he had a diastolic murmur at the accessory aortic area, with irradiation to the armpit, and palpable right ventricle (RV). Chest X-ray and echocardiogram showed increased pulmonary flow and RV overload, and then was submitted to cardiac catheterisation.