Spontaneous chordae rupture of tricuspid valve in patient with chronic renal failure

Spontaneous chordae rupture of the tricuspid valve is relatively rare, unlike the mitral valve. We present a 27-year-old male with chronic renal failure on hemodialysis therapy for treatment of parathyroid adenoma. The echocardiography showed the severe tricuspid regurgitation with chordae rupture which was not noted 1 year ago. In addition, the papillary muscle of both mitral and tricuspid valve was shortened and calcified extensively. However, in his clinical history, the specific causes for chordae rupture, such as chest trauma or endocarditis, were not disclosed. It was presumed that dilated right ventricle with volume or pressure overloading and secondary hyperparathyroidism are probably responsible for the chordae rupture of tricuspid valve.