Latent tricuspid valve rupture after motor vehicle accident and routine echocardiography in all chest-wall traumas

Tex Heart Inst J. 2009;36(6):615-7.

Abstract

Blunt chest-wall trauma is common; however, resultant tricuspid valve rupture is rare and can be subtle in its presentation. Transthoracic echocardiography plays a key role in diagnosis. Herein, we report the case of a 42-year-old woman who sustained substantial chest-wall trauma in a high-speed motor vehicle accident. She presented a week later with symptoms of right-heart failure, secondary to flail tricuspid valve leaflets and torrential tricuspid regurgitation. The case of this patient highlights the importance of early diagnosis and elicits discussion of the mechanisms that can underlie delayed tricuspid valve rupture. Because the clinical diagnosis of tricuspid valve rupture can be difficult, we believe that echocardiography should be used early and, if necessary, repeatedly in all patients who sustain blunt chest-wall trauma.

Keywords: Accidents, traffic; chordae tendineae/injuries; echocardiography; heart injuries/diagnosis; heart valves/injuries/surgery; rupture; thoracic injuries/complications/ultrasonography; time factors; tricuspid valve/injuries/surgery; wounds, nonpenetrating/complications/diagnosis/ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic*
  • Adult
  • Blood Vessel Prosthesis Implantation
  • Diuretics / therapeutic use
  • Early Diagnosis
  • Echocardiography, Doppler, Color*
  • Echocardiography, Transesophageal*
  • Female
  • Heart Failure / diagnostic imaging*
  • Heart Failure / drug therapy
  • Heart Failure / etiology
  • Heart Injuries / diagnostic imaging*
  • Heart Injuries / etiology
  • Heart Injuries / therapy
  • Humans
  • Predictive Value of Tests
  • Severity of Illness Index
  • Treatment Outcome
  • Tricuspid Valve / diagnostic imaging*
  • Tricuspid Valve / injuries
  • Tricuspid Valve Insufficiency / diagnostic imaging*
  • Tricuspid Valve Insufficiency / etiology
  • Tricuspid Valve Insufficiency / therapy
  • Wounds, Nonpenetrating / diagnostic imaging*
  • Wounds, Nonpenetrating / etiology
  • Wounds, Nonpenetrating / therapy

Substances

  • Diuretics