Aortic valve injury following blunt chest trauma

Heart valve injury following blunt chest trauma of car accidents is increasing. Although aortic valve involvement is rare, however, in survivors of blunt cardiac trauma it is the most commonly involved valve and the most frequent valve lesion is isolated injury of the noncoronary cusp of aortic valve.

A 31-year-old man with a history of car accident (five months before) was referred to our clinic because of shortness of breath. A holo-diastolic blowing murmur was heard on physical examination. Transesophageal echocardiography demonstrated severe aortic insufficiency secondary to rupture of the left coronary cusp associated with avulsion of aortic valve commissure.

Since the aortic valve is rarely affected in blunt cardiac injury, it will be generally undiagnosed during the primary evaluation of a patient with blunt chest trauma. However, any patient presenting dyspnea after chest trauma should be examined for suspected aortic valve injury.