Tricuspid Regurgitation Due to Blunt Chest Trauma. Report of a Case and Review of the Literature.

Abstract

SUMMARYA 25-year-old female developed high-grade atrioventricular block and markedly elevated central venous pressure after sustaining a crushing injury to the chest while driving a car. An echocardiographic examination with color Doppler revealed severe tricuspid regurgitation due to a torn papillary muscle. An extensive review of the literature showed the following: 1) correct diagnosis is often delayed because of coexisting multisystem involvement and the subtleness of abnormal physical signs, 2) identification of abnormally elevated right atrial pressure with a prominent "v" wave, and characteristic electrocardiogram appeared to be the key to early diagnosis, and 3) the final diagnosis may be confirmed by echocardiography with Doppler and/or cardiac catheterization. The role of echocardiographic examination with color Doppler technique deserves special emphasis because the final diagnosis can be easily reached during the acute phase at the bedside noninvasively. (Jpn Heart J 34: 361-375, 1993.)

The Double Jeopardy of Blunt Chest Trauma: A Case Report and Review

“…Patients usually have elevated jugular venous pressures with a prominent V‐wave, the presence of a right‐sided gallop, hepatomegaly, and peripheral edema. Electrocardiographic abnormalities including atrial fibrillation, right bundle branch block, and right ventricular enlargement may be present 16 . Chest roentgenogram (CXR) commonly shows right atrial and ventricular enlargement without pulmonary edema.…”

“…Electrocardiographic abnormalities including atrial fibrillation, right bundle branch block, and right ventricular enlargement may be present. 16 Chest roentgenogram (CXR) commonly shows right atrial and ventricular enlargement without pulmonary edema. Pulmonary artery catheterization reveals elevated right atrial pressures with a prominent V-wave which may result in "ventricularization" of the right atrial pressure in severe cases.…”