Latent tricuspid valve rupture after motor vehicle accident and routine echocardiography in all chest-wall traumas.
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.
Khurana
Suchi
S
Cardiovascular Investigations Unit, Royal Adelaide Hospital, Adelaide 5000, SA, Australia. suchi.khurana@gmail.com
Puri
Rishi
R
Wong
Dennis
D
Dundon
Benjamin K
BK
Brown
Michael A
MA
Worthley
Matthew I
MI
Worthley
Stephen G
SG
D000063:Accidents, Traffic; D000328:Adult; D019917:Blood Vessel Prosthesis Implantation; D004232:Diuretics / Q000627:therapeutic use; D042241:Early Diagnosis; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D006801:Humans; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000293:injuries; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy
D004232:Diuretics