Cardiac abnormalities following blunt chest trauma can range from minor ST changes to arrhythmias, cardiac rupture, cardiogenic shock and death. A normal electrocardiogram (ECG) on presentation does not guarantee the absence of myocardial injury, and with no gold standard test to detect the condition, myocardial contusion is often identified only at autopsy. We describe the late presentation of evolving and dynamic conduction abnormalities on the ECG, including a sinusoidal conduction pattern, in a young trauma patient. This sequence of conduction abnormalities has not previously been observed and we discuss the potential explanations.
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