Cardiac sequelae of blunt chest traumas are important considerations and can sometimes require urgent intervention. These include cardiac tamponade, cardiac chamber rupture, valvular disruption, and very rarely injury to coronary vessels resulting in spasms, occlusions or dissection. Approach to blunt chest trauma includes the usual primary and secondary survey as per ATLS guidelines but should include adjuvants to the primary survey including Chest Xray, eFAST and an initial electrocardiography (ECG).1 Repeated ECG readings and troponin evaluation can often be overlooked in a trauma scenario where priorities may include obtaining further imaging with computed tomography (CT) or managing more obvious injuries. It may be difficult to determine whether chest pain in a patient with significant thoracic injury is cardiac or related to other injuries, for example rib fractures. Coronary vessel injury is often not appreciated on imaging initially, placing the importance for emergency physicians and trauma surgeons to be cognisance in obtaining early and repeated ECG and troponin evaluations.2 Myocardial infarction due to coronary vessel injury is a rare consequence of blunt chest trauma with disastrous consequences if missed. We will describe a case in which a repeated ECG and troponin testing assisted in the early diagnosis of a right coronary artery occlusion requiring stenting.