Which of the following diagnosis is the most probable one and why: myocarditis, myocardial contusion or myocardial infarction?
The most probable and the correct one is myocardial contusion. Late enhancement is seen, which is transmural and this effectively rules out myocarditis. So, we are left with the choice of myocardial infarction and contusion. Both are possible, but patch of late enhancement and oedema is small and does not follow vascular territory. Besides, on a close look, fractured sternum can be seen at the same level where myocardial late enhancement is seen. This indicates myocardial contusion, rather than infarction due to coronary artery occlusion.
Fractured sternum exactly at the level of myocardial contusion.