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[Traumatic mitral insufficiency: a case report].

H Gomibuchi, K Ito, M Shimizu

    Journal of Cardiography
    |March 1, 1985
    PubMed
    Summary
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    A chest trauma led to mitral valve prolapse and severe regurgitation in a young man. Surgical repair was successful, highlighting trauma-induced cardiac damage.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Trauma Medicine

    Background:

    • A 25-year-old male presented with dyspnea six years after chest trauma.
    • No prior history of rheumatic fever or endocarditis.

    Observation:

    • Physical exam revealed a significant apical holosystolic murmur, accentuated third heart sound, and hepatomegaly.
    • Electrocardiogram showed sinus tachycardia, left atrial overload, and left ventricular hypertrophy.
    • Echocardiography demonstrated a prolapsed posterior mitral leaflet; cardiac catheterization confirmed severe mitral regurgitation and elevated pulmonary pressures.

    Findings:

    • Ruptured chordae tendineae of the posterior mitral leaflet were identified during surgery.
    • Histology showed myxomatous-like changes in the mitral valve, interpreted as secondary to hemodynamic stress.

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    Implications:

    • Chest trauma can cause delayed-onset severe mitral regurgitation due to chordal rupture.
    • Mitral valve replacement is an effective treatment for trauma-induced severe mitral regurgitation.
    • Histopathological findings suggest hemodynamic stress can induce secondary myxomatous changes in heart valves.