Khurana Suchi, Puri Rishi, Wong Dennis, Dundon Benjamin K, Brown Michael A, Worthley Matthew I, Worthley Stephen G
Cardiovascular Investigations Unit, Royal Adelaide Hospital, Adelaide 5000, SA, Australia.
Tex Heart Inst J. 2009;36(6):615-7.
Blunt chest-wall trauma is common; however, resultant tricuspid valve rupture is rare and can be subtle in its presentation. Transthoracic echocardiography plays a key role in diagnosis. Herein, we report the case of a 42-year-old woman who sustained substantial chest-wall trauma in a high-speed motor vehicle accident. She presented a week later with symptoms of right-heart failure, secondary to flail tricuspid valve leaflets and torrential tricuspid regurgitation. The case of this patient highlights the importance of early diagnosis and elicits discussion of the mechanisms that can underlie delayed tricuspid valve rupture. Because the clinical diagnosis of tricuspid valve rupture can be difficult, we believe that echocardiography should be used early and, if necessary, repeatedly in all patients who sustain blunt chest-wall trauma.
钝性胸壁创伤很常见；然而，由此导致的三尖瓣破裂很少见，其表现可能很隐匿。经胸超声心动图在诊断中起关键作用。在此，我们报告一例42岁女性患者，她在高速机动车事故中遭受了严重的胸壁创伤。一周后，她因连枷样三尖瓣叶和严重三尖瓣反流继发右心衰竭症状前来就诊。该患者的病例突出了早期诊断的重要性，并引发了对延迟性三尖瓣破裂潜在机制的讨论。由于三尖瓣破裂的临床诊断可能困难，我们认为对于所有遭受钝性胸壁创伤的患者，应尽早且必要时反复使用超声心动图。
