| Traumatic tricuspid regurgitation and right-to-left intra-atrial shunt--an unusual complication of a horse-kick. | |
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MedLine Citation:
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PMID: 20666059 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A 63-year-old male presented with sudden onset chest pain and dyspnoea following a kick to the praecordium while gelding a horse. Transthoracic echocardiography showed evidence of flail tricuspid valve leaflets, severe tricuspid regurgitation and a widely patent foramen ovale with a right-to-left shunt. Due to progressive severe systemic hypoxemia the patient underwent emergent surgical intervention. Operative findings confirmed rupture of the anterior and septal tricuspid valve papillary muscles. Successful papillary muscle reattachment was performed in association with tricuspid annuloplasty and suture closure of his patent foramen ovale. Disruption of the tricuspid valve is well described as consequence of blunt trauma to the chest wall and is often well tolerated, coming to light many years post injury. Valve disruption due to rupture at the papillary muscle level, however, typically results in greater severity of tricuspid regurgitation and the abrupt rise in right intra-atrial pressure may lead to a right-to-left shunt across a patent foramen ovale. Where hemodynamic compromise ensues, prompt surgical intervention is mandated. |
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Authors:
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R A Byrne; S Fleming; M Tolan; A Brown |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Irish medical journal Volume: 103 ISSN: 0332-3102 ISO Abbreviation: Ir Med J Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-07-29 Completed Date: 2010-08-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0430275 Medline TA: Ir Med J Country: Ireland |
Other Details:
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Languages: eng Pagination: 55-7 Citation Subset: IM |
Affiliation:
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CResT Directorate, St. James's Hospital, St. James's St, Dublin. byrne@dhm.mhn.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Heart Injuries / etiology* Horses Humans Male Middle Aged Papillary Muscles / injuries* Prolapse Tricuspid Valve Insufficiency / etiology* Wounds, Nonpenetrating / complications* |
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