Background: Myocardial contusion is a potentially life threatening condition, which should be considered in patients with a compatible thoracic trauma. Guidelines for diagnosis and determination of management are non-existent.
Case description: A 51-year-old man arrived at the accident and emergency department with thoracic trauma after being knocked down by a bus. A myocardial contusion was diagnosed based on the ECG and elevated high-sensitivity (hs) troponin levels. Cardiac ultrasound revealed no abnormalities. No complications occurred during 48 hours of cardiac monitoring.
Conclusion: In patients with thoracic trauma, a combination of ECG abnormalities and raised hs troponin levels indicates myocardial contusion. Cardiac ultrasound is required in these patients if they are haemodynamically instable or suffer clinical deterioration. Observation using cardiac rhythm monitoring is necessary in all patients with myocardial contusion, because of the risk of complications such as life-threatening cardiac arrhythmias.