Theodoropoulos Ioannis, Cheeyandira Abhiman, Tortella Bartholomew J
Department of Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
J Emerg Med. 2013 Aug;45(2):175-7. doi: 10.1016/j.jemermed.2012.11.105. Epub 2013 Jun 15.
Cardiac valve injury after blunt chest trauma is extremely rare, and the tricuspid valve is most commonly affected because of the anterior location of the right ventricle. Tricuspid valve insufficiency can range from a subclinical presentation to acute cardiac failure.
Diagnosis is difficult in trauma patients because hypotension is usually attributed to hemorrhage and anatomical cardiac injuries might be overlooked.
This is a case of a 70-year-old patient with a history of rheumatic heart disease who suffered a complete rupture of her papillary muscles leading to tricuspid insufficiency after a motor vehicle collision. She presented with third-degree atrioventricular block.
Consideration of screening for anatomical heart injuries in blunt trauma patients with new onset dysrhythmias is recommended to explain hypotension not attributable to hemorrhage.
钝性胸部创伤后心脏瓣膜损伤极为罕见，由于右心室位于前方，三尖瓣最常受累。三尖瓣关闭不全的程度可从亚临床表达到急性心力衰竭。
创伤患者的诊断困难，因为低血压通常归因于出血，心脏解剖损伤可能被忽视。
这是一名70岁有风湿性心脏病史的患者，在机动车碰撞后发生乳头肌完全断裂，导致三尖瓣关闭不全。她表现为三度房室传导阻滞。
对于新发心律失常的钝性创伤患者，建议考虑筛查心脏解剖损伤，以解释非出血性低血压。
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