Acute Mitral Regurgitation After Blunt Chest Trauma: A Case Report

Area of Science:

• Cardiology
• Trauma Surgery

Background:

• Myocardial contusion is the most frequent cardiac injury following blunt chest trauma (BCT).
• Isolated traumatic valve injury is an uncommon consequence of BCT.

Observation:

• A 60-year-old male presented with worsening heart failure symptoms three weeks after blunt chest trauma.
• Initial diagnosis was chest wall contusion; however, progressive dyspnea prompted further investigation.
• A holosystolic murmur was detected on physical examination.

Findings:

• Transthoracic echocardiography revealed severe acute mitral regurgitation (MR) due to torn chordae tendineae and posterior leaflet prolapse.
• Surgical exploration confirmed torn chordae tendineae and a leaflet tear, with successful mitral valve repair.
• Pathology excluded endocarditis and myxomatous degeneration as causes of chordal rupture.

Implications:

• This case highlights the importance of considering isolated valve injury in patients with BCT, even without initial apparent cardiac damage.
• Echocardiography is vital for timely and accurate diagnosis of cardiac lesions in the context of chest trauma.
• Prompt diagnosis and intervention can prevent further cardiac deterioration and improve patient outcomes.