Case Report: Chronic Tricuspid Regurgitation Bifascicular Block Due to Blunt Chest Trauma

Perlroth, Mark G.; Hazan, E; Lecompte, Y; Gougne, G

doi:10.1097/00000441-198602000-00008

Cited by 27 publications

(18 citation statements)

References 27 publications

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“…An important cause of isolated TR in the current era, it may be associated with a delayed presentation 12. Most commonly the acute rise in right ventricular cavity pressure results in chordal rupture, but papillary muscle or leaflet tears have also been reported 12 13…”

Section: Aetiology and Mechanisms Of Trmentioning

confidence: 99%

Tricuspid regurgitation: contemporary management of a neglected valvular lesion

Irwin

Luckie

Khattar

2010

Postgraduate Medical Journal

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Right-sided cardiac valvular disease has traditionally been considered less clinically important than mitral or aortic valve pathology. However, detectable tricuspid regurgitation (TR) is common and recent data suggest that significant TR can lead to functional impairment and reduced survival, particularly in patients with concomitant left-sided valvular disease. The tricuspid valve is a complex anatomical structure and advances in three dimensional echocardiography and cardiac MRI have contributed to a greater understanding of tricuspid valve pathology. These imaging techniques are invaluable in determining the aetiology and severity of TR, and provide an assessment of right ventricular function and pulmonary artery pressure. TR is more prevalent in women and those with a history of myocardial infarction and heart failure. It also occurs in about 10% of patients with rheumatic heart disease. Chronic severe TR may have a prolonged clinical course culminating in the development of fatigue and poor exercise tolerance due to a reduced cardiac output. Approximately 90% of cases of TR are secondary to either pulmonary hypertension or intrinsic right ventricular pathology and about 10% are due to primary tricuspid valve disease. Primary causes such as Ebstein's anomaly, rheumatic disease, myxomatous changes, carcinoid syndrome, endomyocardial fibrosis, and degenerative disease have characteristic morphological features readily identifiable by echocardiography. Ascertaining an accurate right ventricular systolic pressure is important in separating primary from secondary causes as significant TR with a pressure <40 mm Hg implies intrinsic valve disease. Cardiac MRI may be indicated in those with inadequate echocardiographic images and is also the gold standard for the evaluation of right ventricular function and morphology. The assessment of leaflet morphology, annular dimensions, and pulmonary artery pressure are particularly important for determining subsequent management. Along with appropriate treatment of the underlying cause of TR and pulmonary hypertension, management guidelines indicate a move towards more aggressive treatment of TR. In those undergoing left-sided valve surgery, tricuspid valve repair is universally recommended in the presence of severe coexistent TR; in those with isolated severe TR, surgery is recommended in the presence of symptoms or progressive right ventricular dilatation or dysfunction.

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Section: Aetiology and Mechanisms Of Trmentioning

confidence: 99%

Tricuspid regurgitation: contemporary management of a neglected valvular lesion

Irwin

Luckie

Khattar

2010

Postgraduate Medical Journal

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“…Acute elevation of the right intraventricular pressure results in injury of the tricuspid valve apparatus. 2,4 The most frequently reported mechanism of injury is chordal rupture, followed by rupture of the anterior papillary muscle and leaflet tear, primarily of the anterior leaflet. 4 The treatment for TTR is usually surgical, preferably valve repair.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 The most frequently reported mechanism of injury is chordal rupture, followed by rupture of the anterior papillary muscle and leaflet tear, primarily of the anterior leaflet. 4 The treatment for TTR is usually surgical, preferably valve repair. Although chordal rupture is associated with a more benign course extending from 10 to 25 years, papillary muscle rupture becomes symptomatic and requires operation, usually within weeks to months.…”

Section: Discussionmentioning

confidence: 99%

A Case of Traumatic Tricuspid Valve Regurgitation Caused by Blunt Chest Trauma

Nelson

Wells

2007

Journal of the American Society of Echocardiography

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“…The reported frequency of each type of injury is highest for chordal rupture, followed by rupture of the papillary muscle and leaflet tear (2, 11, 12). Chordal rupture is associated with a more insidious history extending from 10 to 25 yr, whereas papillary muscle rupture becomes symptomatic earlier.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Tricuspid Regurgitation Following Cardiac Massage

Nam

Lee

et al. 2007

J Korean Med Sci

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We report a 66-yr-old male patient who developed tricuspid regurgitation secondary to internal cardiac massage. After uneventful off-pump coronary artery bypass surgery, the subject experienced cardiac arrest in the intensive care unit. External cardiac massage was initiated and internal cardiac massage was performed eventually. A transesophageal echocardiography revealed avulsion of the anterior papillary muscle and chordae to the anterior leaflet after successful cardiopulmonary resuscitation. Emergency repair of the papillary muscle was performed under cardiopulmonary bypass.

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Case Report: Chronic Tricuspid Regurgitation Bifascicular Block Due to Blunt Chest Trauma

Cited by 27 publications

References 27 publications

Tricuspid regurgitation: contemporary management of a neglected valvular lesion

Tricuspid regurgitation: contemporary management of a neglected valvular lesion

A Case of Traumatic Tricuspid Valve Regurgitation Caused by Blunt Chest Trauma

Traumatic Tricuspid Regurgitation Following Cardiac Massage

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