Severe Aortic and Tricuspid Valve Regurgitation after Blunt Chest Trauma: An Unusual Presentation

TRAUMATIC AORTIC VALVE INJURY AFTER BLUNT CHEST TRAUMA

Traumatic aortic valve regurgitation is a rare but potentially fatal complication of blunt chest trauma. We present the case of a 68-year-old woman who suffered from severe traumatic aortic valve regurgitation after a car accident. The patient was successfully treated by surgical replacement of the aortic valve with a biological prosthesis.

Traumatic Injury to Both Atrioventricular Valves

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BCI encompasses a spectrum of cardiac injuries.

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BCI should be considered in all patients with major thoracoabdominal trauma.

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TEE is an excellent imaging method for evaluating BCI, including atrioventricular valve injury.

Traumatic tricuspid regurgitation following equine related blunt chest trauma and review of the literature

Myocardial injury following blunt chest trauma may be difficult to detect. We advocate for cardiac screening in such scenarios. Observation versus intervention should be based on symptoms and the degree of intracardiac disease.

An unfortunate case of acute aortic regurgitation: Isolated aortic valve prolapse following a motor vehicle accident

We present an unfortunate case of severe acute aortic regurgitation (AR) following a motor vehicle accident (MVA) linked to isolated aortic valve prolapse, with no evidence of aortic root disruption or other valvular pathology missed on initial presentation. A 55-year-old gentleman, with known hypertension, was brought into the emergency department following a MVA, where he sustained severe intra-thoracic injuries. A bedside transthoracic echocardiogram (TTE) revealed a trileaflet aortic valve with evidence of mal-coaptation and severe AR. A computed tomography angiography of the thorax, however, failed to demonstrate evidence of dissection along the aortic root or ascending aorta. Following successful weaning off ventilatory support, the patient was discharged, but he presented back within a week with worsening dyspnoea and palpitations. Examination and investigation supported a diagnosis of acute heart failure with evident severe AR on repeat TTE. Transoesophageal echocardiography was performed, revealing prolapsed right and non-coronary cusps which were not seen in previous studies but absent evidence of the aortic root, ascending and descending aorta dilatation or dissection. Valvular complications rarely occur following blunt chest wall trauma, often involving right-sided valves due to their proximity to the sternum. Although aortic valve disruption can occur following MVAs, it is often associated with trauma to the aorta. Based on our literature search, there have been only a handful of reported cases of severe acute AR due to isolated prolapse or ruptured aortic valves in the absence of aortic valve perforation, aortic root disruption or dissection and other valvular abnormalities following trauma.

Case Report: Lessons Learned From Aortic Valve Rupture After Blunt Chest Trauma

Aortic valve rupture (AVR) due to blunt chest trauma is extremely rare in the pediatric population, and little attention has been paid to such damages. Early diagnosis of AVR may not be easy in patients with multiple competing injuries and poor acoustic windows. We report a case of delayed diagnosis of AVR in a 12-year-old boy after falling from a height of 15 meters, who presented with recurrent hemoptysis and ventilator dependence. This rare case highlights the importance of performing transesophageal echocardiography in trauma patients when the images of transthoracic echocardiography are suboptimal, especially for those presenting with signs and symptoms suggestive of heart failure. The overall prognosis of aortic valve replacement is good.