J Cardiovasc Ultrasound.  2011 Mar;19(1):41-44. 10.4250/jcu.2011.19.1.41.

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

• Jin HY
• Jang JS
• Seo JS
• Yang TH
• Kim DK
• Kim DK
• Kim U
• Seol SH
• Kim DI
• Kim DS

• KMID: 2135433
• DOI: http://doi.org/10.4250/jcu.2011.19.1.41

Abstract

Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma. With the increase in the number of automobile accidents, traumatic tricuspid regurgitation has become an important problem after blunt chest trauma. It has been reported more frequently because of better diagnostic procedures and a better understanding of the pathology. The early diagnosis of traumatic tricuspid regurgitation is important because traumatic tricuspid injury could be effectively corrected with reparative techniques, early operation is considered to relieve symptoms and to prevent right ventricular dysfunction. Echocardiography can reveal the cause and severity of regurgitation. We experienced a case of tricuspid regurgitation after blunt chest trauma early diagnosis and valve repair were performed. This case reminds the physicians in the emergency department should be aware of this potential complication following non-penetrating chest trauma and echocardiography is useful and should play an early role.

Keyword

Tricuspid regurgitation; Chest injury; Echocardiography; Thoracic surgery

MeSH Terms

Automobiles
Early Diagnosis
Echocardiography
Emergencies
Papillary Muscles
Rupture
Thoracic Injuries
Thoracic Surgery
Thorax
Tricuspid Valve Insufficiency
Ventricular Dysfunction, Right

Figure

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  Fig. 1 The electrocardiogram showed complete right bundle branch block with posterior fascicular block.

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  Fig. 2 The transthoracic echocardiography (A) and transesophageal echocardiography (B) showed prolapse of the septal (arrows) and anterior (arrow heads) tricuspid valve leaflet with large portions of the valve and the subvalvular appratus protruding into the right atrium indicating rupture of both anterior and posterior papillary muscle.

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  Fig. 3 The color-flow Doppler transthoracic echocardiography showed severe tricuspid regurgitation (A). Peak velocity of tricuspid valve was 1.62 m/sec and right ventricular systolic pressure was 20.5 mmHg (B).

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  Fig. 4 The transthoracic echocardiography after tricuspid valve repair showed satisfactory leaflet coaptation (A) and repaired papillary muscle (B).

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