Traumatic tricuspid valve rupture presenting as third-degree atrioventricular block

Area of Science:

• Cardiology
• Trauma Surgery
• Cardiac Surgery

Background:

• Cardiac valve injury from blunt chest trauma is uncommon.
• The tricuspid valve is frequently affected due to the right ventricle's anterior position.
• Tricuspid valve insufficiency can manifest subtly or lead to acute heart failure.

Observation:

• Diagnosis of cardiac injuries in trauma patients is challenging.
• Hypotension in trauma is often misattributed to hemorrhage, masking cardiac issues.
• A case report details a 70-year-old with rheumatic heart disease experiencing tricuspid insufficiency post-motor vehicle collision.

Findings:

• The patient presented with complete papillary muscle rupture and third-degree atrioventricular block.
• This case highlights a rare but severe consequence of blunt chest trauma.
• Tricuspid insufficiency was the primary cardiac complication.

Implications:

• Screening for anatomical heart injuries should be considered in blunt trauma patients.
• New-onset dysrhythmias in trauma patients warrant investigation for cardiac injury.
• This approach aids in diagnosing hypotension not explained by hemorrhage.