Tricuspid and Mitral Valve Regurgitation with Bi-fascicular Block Following a Horse Kick

Abstract

A 40-year-old man was transferred to our hospital following an isolated horse kick injury to the anterior chest wall. The case showed bi-fascicular block, severe tricuspid valve regurgitation due to ruptured chordae tendineae of the anterior leaflet, moderate mitral valve regurgitation due to prolapse of mitral anterior leaflet, and hypokinetic motion of the inferior septal wall. Both tricuspid and mitral insufficiency were completely repaired by a surgical operation. Fortunately, these injuries were not fatal in this case, but the comprehensive assessment of cardiac damage and careful observation are important for managing patients with cardiac injury.

Traumatic Injury to Both Atrioventricular Valves

“…2 , 3 , 4 Motor vehicle accidents are the most common mechanism of traumatic injury to the heart valves, but other causes have been described, including falls and kicks from animals. 4 , 5 However, the condition is likely underappreciated given that postmortem and forensic data show that BCI complicates up to 20% of major trauma, with valvular injury contributing to 4% of cases. 6 , 7 Postmortem data suggest that the aortic and tricuspid valves are the most commonly injured heart valves.…”

Tricuspid valve repair via partial sternotomy for traumatic valve insufficiency

“…In the review of five surgical cases reported in Japan from 2010 to 2018, the types of trauma were the motorcycle accidents in two cases and the other cases were fall, horse kick, and penetrating trauma. [1][2][3][4][5] It is notable that all patient in this series had anterior leaflet pathology. Blunt chest trauma accompanying the tremendous impact on the chest wall easily injures the anterior leaflet chordae and papillary muscle because the constructions are attached to the right heart free wall.…”