{'fraction_non_alphanumeric': 0.02766798418972332, 'fraction_numerical': 0.006324110671936759, 'mean_word_length': 5.057416267942584, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Myocardial contusion in an 8-year-old boy: a kick to the heart.

Myocardial contusion injury (MCI) may occur as a rare complication of blunt thoracic trauma, presenting with possible electrocardiogram (ECG) changes, rhythm disturbances, left ventricular systolic dysfunction, or troponin elevation. We present an 8-year-old boy with MCI after a kick to the chest by a horse and describe the use of diagnostic modalities and his clinical course.

An 8-year-old previously healthy boy presented 2 hours after he was kicked in the chest by a horse. He was awake, alert, and oriented with normal vital signs, including a heart rate of 84 bpm. Physical examination was significant for superficial abrasions over his left chest and left chin. He sustained an incomplete distal ulnar fracture. Chest radiograph and a computed tomography scan without contrast of the chest and abdomen demonstrated extensive bilateral pulmonary contusions and a small right-sided pneumothorax.

The initial ECG demonstrated bifascicular block (right bundle branch block and left anterior fascicular block; Figure 1), a well described, albeit rare, transient conduction abnormality that can be seen secondary to myocardial edema after significant MCI.1 Troponin I level at presentation was …