1
|
Radovanovic N, Prodanovic M, Radosavljevic-Radovanovic M, Bilbija I, Petrovic O, Lojovic N, Kecman E, Djekic A, Radovanovic M, Matic D. Late presentation of traumatic tricuspid valve chordal rupture and pericardial rupture with cardiac herniation: a case report. BMC Cardiovasc Disord 2024; 24:44. [PMID: 38218797 PMCID: PMC10787964 DOI: 10.1186/s12872-024-03716-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 01/06/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Although chest trauma happens very often, accompanying tricuspid valve injuries occur rarely and may be manifested by scarce symptoms and signs. Pericardial rupture with cardiac herniation is even a bigger rarity. Transthoracic echocardiography plays a key role in the diagnosis of valve injuries but is of limited value in cardiac herniation. CASE PRESENTATION We present the case of 58-year-old man who experienced severe chest trauma in a car accident. Symptoms of right heart failure occurred 10 years after the injury, due to the loss of tricuspid leaflet support caused by the rupture of tendinous chords with significant tricuspid regurgitation. Intraoperatively, old posttraumatic pericardial rupture into left pleura was also found, with partial cardiac herniation and pressure of the edge of pericardium on all left-sided coronary arteries simultaneously. The patient was successfully operated and is free of symptoms 4 years later. CONCLUSIONS This case emphasizes the importance of timely diagnosis and underlines a mechanism that leads to delayed rupture of the tricuspid valve apparatus. Repeated echocardiography in all patients who experienced chest trauma could be of great importance. Also, given the limited value of echocardiography in posttraumatic pericardial rupture and cardiac herniation, cardiac computed tomography should be performed.
Collapse
Affiliation(s)
- Nebojsa Radovanovic
- Cardiology Clinic, University Clinical Center of Serbia, Dr Koste Todorovića 8, Belgrade, 11000, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Maja Prodanovic
- Cardiology Clinic, University Clinical Center of Serbia, Dr Koste Todorovića 8, Belgrade, 11000, Serbia
| | - Mina Radosavljevic-Radovanovic
- Cardiology Clinic, University Clinical Center of Serbia, Dr Koste Todorovića 8, Belgrade, 11000, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ilija Bilbija
- Cardiac Surgery Clinic, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Olga Petrovic
- Cardiology Clinic, University Clinical Center of Serbia, Dr Koste Todorovića 8, Belgrade, 11000, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nina Lojovic
- Cardiology Clinic, University Clinical Center of Serbia, Dr Koste Todorovića 8, Belgrade, 11000, Serbia
| | - Emilija Kecman
- Cardiology Clinic, University Clinical Center of Serbia, Dr Koste Todorovića 8, Belgrade, 11000, Serbia
| | - Aleksandar Djekic
- Cardiology Clinic, University Clinical Center of Serbia, Dr Koste Todorovića 8, Belgrade, 11000, Serbia
| | | | - Dragan Matic
- Cardiology Clinic, University Clinical Center of Serbia, Dr Koste Todorovića 8, Belgrade, 11000, Serbia.
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| |
Collapse
|