[Myocardial contusion and pericardial effusion after blunt chest trauma].

We have read with great interest the recent and interesting contribution by Dr. Francia et al. about a case of late cardiac tamponade due to myocardial contusion. We would like to make certain observations regarding a similar case that we have recently treated. A 70-year-old woman came to our emergency department after having undergone the Heimlich maneuver because of choking. Upon admittance, the patient was conscious, oriented, with stable respiratory function and hemodynamics. She only presented mild pain on palpation in the lower sternal region, with no associated signs or symptoms. Three hours after hospitalization, ECG and myocardial enzymes presented no alterations (troponin I: 0.20 ng/ml). Chest X-ray showed a simple sternal fracture in the distal third of the sternum. The patient remained under observation, and after 8 h her enzymes began to rise progressively (troponin I: 0.62),