Sirs: Contusio cordis is characterized by hemorrhage and patchy fibrosis as a result of strong kinetic forces. Contusio cordis most commonly develops after blunt chest traumas [1, 2]. Cardiac magnetic resonance (CMR) imaging can be a useful tool to visualize the underlying pathological process in such patients. Here, we report on a highly unusual case of cardiac contusion caused by chest compressions during resuscitation that was detected by CMR. A 53-year-old male collapsed as a spectator watching a football game. The onsite emergency services found a pulseless patient and initiated immediate onsite cardiopulmonary resuscitation. The initial onsite ECG showed asystole that in the course of resuscitation converted into a stable sinus rhythm. The patient received epinephrine. No defibrillation was used. The patient was admitted to our Emergency Department. The past medical history of the patient was unremarkable. A thorough examination of the patient, including chest X-ray, pulmonary CT scans and a cardiac evaluation including coronary angiography, echocardiography and an EP study did not show any relevant findings except for unspecific pulmonary nodules. There was no family history for hereditary diseases. ECG gave no evidence for channelopathies. 24-h holter ECG and exercise testing were also normal. There was also no history of prior or recent chest trauma. Blood tests showed signs of myocardial injury with an elevated cTroponin T level [0.75 (normal: 0–0.03) lg/dl] and an elevated CK level [683 (normal: 190 or less) U/l] that were associated with unspecific ECG changes in V2 und V3 (Fig. 1a, b). Coronary artery disease could be ruled out (Fig. 1c, d). For further evaluation, 2 days after the initial event, a cardiac MRI in short axis and 4-chamber view was performed (MAGNETOM Avanto 1.5T, Siemens AG Sector Healthcare, Erlangen, Germany). Late gadolinium enhancement (LGE) imaging with PSIR–SSFP revealed a hyperintense area in the right ventricular wall with a hypointense core zone (Fig. 2a) and a regional wall motion abnormality. Contrast enhanced computed tomography (ceCT) was performed (SOMATOM Sensation 64, Siemens AG Sector Healthcare, Erlangen, Germany) to rule out a thrombus as eligible differential diagnosis for the cardiac alteration. ceCT of the heart revealed a regional wall thickness (Fig. 2b) without circumscribed myocardial or endothelial alteration. On the follow-up cardiac MRI, 1 week later, both the size of the suspicious area and the regional wall motion abnormality were declining (Fig. 2c). On day 9 after the initial event, the blood markers were back in normal range. A 2D transthoracic echocardiographic examination showed a completely normal cardiac function without any abnormalities in regional cardiac wall motion (Fig. 1c, d). After surviving sudden cardiac arrest, the patient received an ICD. It was for this reason that further cardiac MRI studies especially with regard to detection of myocardial fibrosis could not be undertaken. The patient was regularly examined for ICD follow-ups with no further events over 2 years. Long-term follow-up ceCT was performed 2 years later, confirming a complete resolution of wall thickness in CT (Fig. 2d). We here describe a patient with no evident cause for cardiac arrest. However, we were able to describe a set of findings that was highly suggestive of a cardiac contusion caused by forced CPR [3, 4]. The laboratory findings of T. Reiter (&) O. Ritter M. Beer B. Petritsch University Hospital Wuerzburg, Wuerzburg, Germany e-mail: reiter.theresa@googlemail.com; Reiter_T@medizin.uni-wuerzburg.de