Traumatic tricuspid insufficiency: a case followed for 32 years, with a note on early sources

A healthy young man suffered nonpenetrating chest trauma in an automobile accident in August 1962, sustaining tricuspid valve disruption and insufficiency, a rare event. Clinical diagnosis was confirmed by cardiac catherization, but valve replacement did not take place for 10 years. Since initial valve replacement he has had two further operations to deal with valve malfunction resulting in recurrent tricuspid stenosis. He had been followed, in various hospitals, for more than 32 years. Traumatic tricuspid insufficiency has become more common with the rise of car accidents and steering wheel trauma. It is characterized by the subtlety of presentation in its mainly young male victims, although it may be suspected from simple bedside examination, and by the frequently long delay between injury and overt clinical problem. The unusual history of the earliest clinical descriptions is reviewed.