We wanted to evaluate whether current screening techniques effectively determine a patient's need for hospital admission and intensive care monitoring after blunt chest trauma. Consequently, we reviewed 104 consecutive admissions for "blunt chest trauma; rule out cardiac contusion." Neither clinical findings, cardiac enzyme levels, chest x-rays, nor ECGs predicted the high-risk patients who would subsequently develop complications related to myocardial contusion. Since only 23% of the study patients developed such complications, the plurality of study patients did not require admission and monitoring. There is, therefore, a definite need to develop new, accurate screening tests for patients at risk for myocardial contusion complications.