Traumatic mitral valve regurgitation: a case report and state-of-the-art review

Abstract

Traumatic mitral valve regurgitation is a rare and often insidious condition. Clinical presentation is variable and influenced by the anatomic structures injured; when papillary muscles are damaged, the clinical presentation is often acute, whereas, in the case of involvement of other anatomic structures of the valvular apparatus (e.g. chordae tendinae), the onset of symptoms may be delayed (days, weeks, or months). Therefore, diagnosis may be belated because of the heterogeneous clinical presentation. Traumatic mitral valve injury should be excluded in patients admitted to the emergency services with blunt chest trauma, in particular when signs or symptoms of acute heart failure occur. Echocardiography, particularly with the transoesophageal approach, may play a pivotal role in this setting. Herein, we present a case of severe mitral regurgitation because of blunt chest trauma and a systematic review of the literature. We examined 192 described cases, classified according to epidemiology, aetiology, anatomic features, clinical presentation, diagnosis, surgical/clinical management and prognosis.

Mitral Valve Pathology

“…The most common cause is blunt chest trauma due to road traffic accident. 18 Papillary muscle rupture in ischaemic heart disease Papillary muscle rupture of the mitral valve is a rare complication of ischaemic heart disease. It most frequently occurs secondary to acute myocardial infarction involving the papillary muscle which results in rupture and severe regurgitation.…”