Myocardial contusion, (traumatic myocardial dysfunction) is a relatively common complication of blunt trauma. The diagnosis is often elusive. Studies using clinical and laboratory parameters often fail to detect patients with significant myocardial injury. No constellation of clinical signs, electrocardiographic findings, or cardiac enzymes has been sensitive or specific enough to evaluate such patients accurately. Recently, radionuclide angiography was found to be a sensitive indicator of myocardial dysfunction. The authors studied ten patients with blunt thoracic or multisystem trauma who had myocardial dysfunction documented by first-pass radionuclide angiography. Follow-up study within five weeks demonstrated normalization or improvement in ejection fraction and wall motion abnormalities in all patients. Radionuclide angiography is cost effective, can be performed in the emergency department, and can assist in the management of patients with blunt thoracic or multisystem trauma.