Spontaneous Regression Of Severe Traumatic Tricuspid Valve Regurgitation
Toggweiler, S., Turina, J., Jenni, R., & Tanner, F. C. (2010). spontaneous regression of severe traumatic tricuspid valve regurgitation. European heart journal, 31(5), 560. https://doi.org/10.1093/eurheartj/ehp531
View Original Source →Abstract
A 27-year-old male patient was hospitalized after a car accident. In-hospital work-up revealed a subdural haematoma, an unstable C7/Th1 distraction fracture, bilateral pulmonary contusions, and rip fractures with bilateral pneumothorax. On admission, central venous pressure was 25 mmHg with a prominent v-wave. Troponin, cardiac enzymes, and NT-proBNP were elevated. Echocardiography revealed severe tricuspid regurgitation due to partial rupture of the posterior and anterior papillary muscles leading to prolapse of the respective tricuspid valve leaflets. Vena contracta was 12 mm and there was prominent systolic backflow in the hepatic veins. The …
Case Details
Disease Location
Heart
Personal Characteristics
27 years old man hospitalized after a car accident
Clinical Characteristics
Subdural haematoma, unstable c7/th1 distraction fracture, bilateral pulmonary contusions and rip fractures with bilateral pneumothorax. Troponin and cardiac enzymes elevated. Severe tricuspid regurgitation.
Remission Characteristics
Despite tricuspid regurgitation was still severe after hospitalization, 165 days after the accident, fibrosis of the injured papillary muscles was avident, and tricuspid regurgitation became moderate. After 1 year, tricuspid regurgitation was mild and cavity size normalized.
Treatment & Mechanisms
Proposed Remission Mechanisms
Remodelling and scarring of the papillary muscles can provoke a secondary decrease in regurgitation.
Clinical Treatment
29 days of hospitalization