Introduction Physical external trauma to the heart leading to mycocardial muscle contusion, cardiac chamber rupture, valvular disruption. Presentation Symptoms chest discomfort Physical exam hypotension arrythmias signs of MI Evaluation EKG premature ventricular cotractions unexplained sinus tachycardia atrial fibrillation bundle branch block ST changes, may mimic a myocardial infarction Echocardiography Cardiac enzymes