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BMJ case reports2022; 15(5); e248580; doi: 10.1136/bcr-2021-248580

Traumatic avulsion of the tricuspid valve: an unusual cardiac complication of an equine accident.

Abstract: A stablehand in his 20s presented with increasing dyspnoea on exertion and chest pain months after being kicked directly in the chest by a horse. Further investigations revealed severe isolated, primary tricuspid regurgitation due to partial avulsion of the anterior leaflet. Open surgical repair was successfully performed from which he recovered uneventfully with resolution of his symptoms and minimal residual tricuspid regurgitation. Although uncommon, blunt force trauma to the chest is becoming increasingly recognised as a rare cause of tricuspid regurgitation. Symptoms may be insidious, and a high index of suspicion is required to avoid missing the diagnosis.
© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.
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Publication Date: 2022-05-20 PubMed ID: 35606029PubMed Central: PMC9125735DOI: 10.1136/bcr-2021-248580Google Scholar: Lookup
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Summary

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The article presents a case study of a young man who suffered from a rare heart valve damage known as tricuspid valve avulsion, caused by a direct kick from a horse to his chest. This led to severe chest pain and breathing difficulties, which were later treated successfully through open-heart surgery.

Case Details

  • The patient was a stablehand in his 20s, who had been kicked in the chest by a horse months prior.
  • He came to the doctor reporting increasing shortness of breath and chest pain during exertion.

Diagnosis

  • Upon further medical examination, the patient was found to have severe isolated, primary tricuspid regurgitation.
  • This condition was due to partial avulsion (tearing away) of the anterior leaflet of the tricuspid valve in his heart.
  • The tricuspid valve separates the right atrium and the right ventricle of the heart and prevents the backflow of blood. A defect in this valve can lead to regurgitation, where the blood flows backward into the atrium.

Treatment and Recovery

  • The patient underwent successful open-heart surgery to repair the damaged valve.
  • His recovery was uneventful and his symptoms were resolved effectively with minimal residual tricuspid regurgitation.

Study Significance

  • Blunt force trauma to the chest, like a kick from a horse, is increasingly being recognised as a rare cause of tricuspid regurgitation.
  • This kind of injury is unusual and the symptoms may develop gradually over time, therefore a high level of suspicion and thorough medical examination are required to correctly diagnose and treat it.

Cite This Article

APA
White A, Cullen P, Hinchion J. (2022). Traumatic avulsion of the tricuspid valve: an unusual cardiac complication of an equine accident. BMJ Case Rep, 15(5), e248580. https://doi.org/10.1136/bcr-2021-248580

Publication

BMJ case reports
ISSN: 1757-790X
NlmUniqueID: 101526291
Country: England
Language: English
Volume: 15
Issue: 5
PII: e248580

Researcher Affiliations

White, Alexandra
  • Cardiothoracic Surgery, Galway University Hospitals, Galway, Ireland alexandrawhite@rcsi.ie.
Cullen, Paul
  • Cardiothoracic Surgery, Cork University Hospital, Cork, Ireland.
Hinchion, John
  • Cardiothoracic Surgery, Cork University Hospital, Cork, Ireland.

MeSH Terms

  • Accidents
  • Animals
  • Horses
  • Humans
  • Male
  • Thoracic Injuries / complications
  • Thoracic Injuries / surgery
  • Tricuspid Valve / diagnostic imaging
  • Tricuspid Valve / surgery
  • Tricuspid Valve Insufficiency / diagnostic imaging
  • Tricuspid Valve Insufficiency / etiology
  • Tricuspid Valve Insufficiency / surgery
  • Wounds, Nonpenetrating / complications

Conflict of Interest Statement

Competing interests: None declared.

References

This article includes 12 references
  1. Marcolini EG, Keegan J. Blunt Cardiac Injury.. Emerg Med Clin North Am 2015 Aug;33(3):519-27.
    doi: 10.1016/j.emc.2015.04.003pubmed: 26226863google scholar: lookup
  2. Mehrotra D, Dalley P, Mahon B. Tricuspid valve avulsion after blunt chest trauma.. Tex Heart Inst J 2012;39(5):668-70.
    pmc: PMC3461659pubmed: 23109764
  3. Yousef R, Carr JA. Blunt cardiac trauma: a review of the current knowledge and management.. Ann Thorac Surg 2014 Sep;98(3):1134-40.
    doi: 10.1016/j.athoracsur.2014.04.043pubmed: 25069684google scholar: lookup
  4. Chirillo F, Totis O, Cavarzerani A, Bruni A, Farnia A, Sarpellon M, Ius P, Valfrè C, Stritoni P. Usefulness of transthoracic and transoesophageal echocardiography in recognition and management of cardiovascular injuries after blunt chest trauma.. Heart 1996 Mar;75(3):301-6.
    doi: 10.1136/hrt.75.3.301pmc: PMC484291pubmed: 8800997google scholar: lookup
  5. Maisano F, Lorusso R, Sandrelli L, Torracca L, Coletti G, La Canna G, Alfieri O. Valve repair for traumatic tricuspid regurgitation.. Eur J Cardiothorac Surg 1996;10(10):867-73.
    doi: 10.1016/S1010-7940(96)80313-7pubmed: 8911840google scholar: lookup
  6. Arsalan M, Walther T, Smith RL 2nd, Grayburn PA. Tricuspid regurgitation diagnosis and treatment.. Eur Heart J 2017 Mar 1;38(9):634-638.
    doi: 10.1093/eurheartj/ehv487pubmed: 26358570google scholar: lookup
  7. Lapenna E, De Bonis M, Verzini A, La Canna G, Ferrara D, Calabrese MC, Taramasso M, Alfieri O. The clover technique for the treatment of complex tricuspid valve insufficiency: midterm clinical and echocardiographic results in 66 patients.. Eur J Cardiothorac Surg 2010 Jun;37(6):1297-303.
    doi: 10.1016/j.ejcts.2009.12.020pubmed: 20117940google scholar: lookup
  8. Bansal MK, Maraj S, Chewaproug D, Amanullah A. Myocardial contusion injury: redefining the diagnostic algorithm.. Emerg Med J 2005 Jul;22(7):465-9.
    doi: 10.1136/emj.2004.015339pmc: PMC1726836pubmed: 15983078google scholar: lookup
  9. Pasic M, von Segesser L, Carrel T, Jenni R, Turina M. Severe tricuspid regurgitation following blunt chest trauma: indication for emergency surgery.. Eur J Cardiothorac Surg 1992;6(8):455-7.
    doi: 10.1016/1010-7940(92)90073-7pubmed: 1389254google scholar: lookup
  10. Kulik A, Al-Saigh M, Yelle JD, Rubens FD. Subacute tricuspid valve rupture after traumatic cardiac and pulmonary contusions.. Ann Thorac Surg 2006 Mar;81(3):1111-2.
    doi: 10.1016/j.athoracsur.2004.12.027pubmed: 16488736google scholar: lookup
  11. Messika-Zeitoun D, Thomson H, Bellamy M, Scott C, Tribouilloy C, Dearani J, Tajik AJ, Schaff H, Enriquez-Sarano M. Medical and surgical outcome of tricuspid regurgitation caused by flail leaflets.. J Thorac Cardiovasc Surg 2004 Aug;128(2):296-302.
    doi: 10.1016/j.jtcvs.2004.01.035pubmed: 15282468google scholar: lookup
  12. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Muñoz D, Rosenhek R, Sjögren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL. 2017 ESC/EACTS Guidelines for the management of valvular heart disease.. Eur Heart J 2017 Sep 21;38(36):2739-2791.
    doi: 10.1093/eurheartj/ehx391pubmed: 28886619google scholar: lookup

Citations

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