Cardiac iathrogenic lesions can occur during diagnostic or therapeutic procedures. Resistance of the heart to an injury may cause a delay from the traumatic event to onset of the symptomatology or to heart rupture. We describe a rare case cardiac perforation with delayed rupture of the heart in a patient previously submitted to radiation therapy for breast cancer. Cardiocutaneous fistula at the cross-sectional computed tomographic and magnetic resonance imaging findings has not been previously reported, to our knowledge.