Document Detail


Traumatic tricuspid regurgitation and right-to-left intra-atrial shunt--an unusual complication of a horse-kick.
MedLine Citation:
PMID:  20666059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R A Byrne; S Fleming; M Tolan; A Brown
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Irish medical journal     Volume:  103     ISSN:  0332-3102     ISO Abbreviation:  Ir Med J     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-07-29     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0430275     Medline TA:  Ir Med J     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  55-7     Citation Subset:  IM    
Affiliation:
CResT Directorate, St. James's Hospital, St. James's St, Dublin. byrne@dhm.mhn.de
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MeSH Terms
Descriptor/Qualifier:
Animals
Heart Injuries / etiology*
Horses
Humans
Male
Middle Aged
Papillary Muscles / injuries*
Prolapse
Tricuspid Valve Insufficiency / etiology*
Wounds, Nonpenetrating / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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