Blunt injury to the heart ranges from a contusion to a cardiac rupture. Cardiac rupture, however, is uncommon and is associated with a very high mortality rate. We experienced a case of right atrial rupture caused by a compression to the chest wall. The patient was a 19-year-old male who suffered injury by being crushed under an elevator. We suspected cardiac tamponade caused by cardiac rupture with profound shock, elevated central venous pressure, and anterior chest wall bruise. Rapid diagnosis was done by using emergency sonography. Percutaneous pericardiocentesis was done. The patient was sent to O.R., and the right atrial rupture was repaired with a simple suture.