We demonstrate the peculiarities of diagnosis and successful multi-stage treatment of a patient with severe combined trauma and heart rupture complicated by extensive ischemic stroke in early postoperative period. A patient with severe combined injury was treated at the trauma center grade 3 (State Clinical Hospital No. 25, Volgograd) in 2023. We should remember Beck’s triad and possible sternum fracture as a marker of severe chest injury for timely diagnosis of heart rupture with pericardial tamponade. Successful multi-stage treatment of a patient with severe combined trauma and cardiac rupture complicated by extensive ischemic stroke in early postoperative period was demonstrated.