BackgroundSpleen is one of the frequently injured abdominal organs during trauma which could result in intraperitoneal bleeding of life-threatening magnitude. Even though, splenic injury ensuing trivial trauma accounts for a minor fraction of splenic injury and might go unnoticed, delayed or missed diagnosis and management could result in a complicated clinical course.Case DescriptionOne such event is presented here, wherein late diagnosis of an advanced grade splenic injury following a trivial trauma initially presented in disguise as acute myocardial ischemia in a previously healthy South Asian lady in her late 30s. Emergency laparotomy and splenectomy were performed with simultaneous massive transfusion for a 3.5-liter blood loss. She had an uncomplicated clinical course with regular surgical follow-up. ConclusionSplenic injuries might present with atypical symptoms such as uncharacteristic chest pain and shoulder pain, necessitating attending clinicians to have a high degree of suspicion especially in busy units such as the emergency department.