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J Korean Soc Emerg Med > Volume 16(6); 2005 > Article
Journal of The Korean Society of Emergency Medicine 2005;16(6): 684-687.
Delayed Presentation of Mitral Valve Leaflet Perforation Following Blunt Chest Trauma: A Case Report
Hong Won Kim, Seong Gwan Lim, Han Sung Choi, Hoon Pyo Hong, Soo Joong Kim, Myung Chun Kim, Young Gwan Ko
1Department of Emergency Medicine and Division of Cardiology, College of Medicine, KyungHee University, Seoul, Korea. edkmc@chol.com
2Department of Internal Medicine, College of Medicine, KyungHee University, Seoul, Korea.
ABSTRACT
Mitral regurgitation originating from mitral valve leaflet perforation secondary to blunt chest trauma is a rare condition. The mechanisms related with valvular injury are rapid acceleration- deceleration movements of the thorax, compression of the heart between the sternum and vertebrae during early systole or late diastole, and abrupt increase of the intrathoracic pressure followed by cardiac rupture. Transesophageal echocardiography (TEE) is a recommended diagnostic tool and is superior to transthoracic echocardiography (TTE) for diagnosing valvular lesions. Valvular injury causing sudden and severe mitral regurgitation will lead to congestive heart failure and death without operative correction. A high index of suspicion with appropriate diagnostic methods will provide a diagnosis and allow the possibility of operative correction. We report the case of a 45-year-old man with delayed presentation of traumatic mitral valve perforation and review previous reports of blunt traumatic mitral valve injury.
Key words: Blunt chest trauma, Mitral valve, Perforation
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