Traumatic Tricuspid Insufficiency with Chordae Tendinae Rupture: A Case Report and Literature Review

Abstract

With the increase in the number of automobile accidents, traumatic tricuspid insufficiency, a rare complication of non-penetrating blunt chest injury, has become an important problem. This kind of injury has been found more frequently during the last decade, partly because of better diagnostic procedures and a better understanding of the pathology. Here, we report a 22-year-old male patient who suffered chest trauma from an automobile accident. Echocardiography demonstrated tricuspid chordae tendinae rupture with remarkable tricuspid regurgitation. We discuss this case in comparison with the previous literature. This case reminds us that physicians in the emergency department should be aware of this potential complication following non-penetrating chest trauma.

A Case of Traumatic Tricuspid Regurgitation Caused by Multiple Papillary Muscle Rupture

“…The incidence of blunt chest wall trauma and reported traumatic tricuspid regurgitation has been increasing during the last decade 5). However, the diagnosis is difficult because this pathology slowly progress and its presentation can be atypical or asymptomatic, so its incidence rates may be underestimated 2)5)6)…”

Posttraumatic tricuspid valve perforation and severe tricuspid valve regurgitation

“…Cardiac valve damage is less common, and the most frequent traumatic valvular injury occurs on aortic valve, followed by mitral and tricuspid valves. [6,7] Traumatic tricuspid insufficiency is rare, but the frequency of this disease is probably underestimated, as tricuspid regurgitation has generally slowly progress and causes few symptoms. [7] The main mechanism is the compression of the right ventricle between the sternum and spine, when the valves are closed and the ventricular pressure is high.…”

“…[6,7] Traumatic tricuspid insufficiency is rare, but the frequency of this disease is probably underestimated, as tricuspid regurgitation has generally slowly progress and causes few symptoms. [7] The main mechanism is the compression of the right ventricle between the sternum and spine, when the valves are closed and the ventricular pressure is high. [5,8] That generates severe tension on both leaflets and subvalvular structures, causing subsequent rupture.…”

Concomitant Traumatic Coronary Artery Dissection and Tricuspid Valve Injury: A Case Report

“…When a deceleration force is transmitted through the ventricle, especially during the end-diastolic phase, a regurgitant jet can initiate the rupture of a papillary muscle or of the chordae tendineae [12].…”