Acquired cyanotic heart disease secondary to traumatic tricuspid regurgitation. Case report with a review of the literature

Gust H. Bardy, James V. Talano, Sheridan Norman Meyers, Michael Lesch*

*Corresponding author for this work

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

A case of traumatic tricuspid insufficiency leading to right atrial enlargement and to a patent foramen ovale with right to left shunting is presented. Six similar cases previously reported are reviewed. The time course of clinical deterioration was related to the type of tricuspid valve damage incurred. Papillary muscle rupture led to surgery within a year, whereas less severe chordal damage allowed a more benign course that lasted from 10 to 25 years from the time of injury to the time of surgery. Surgical repair of the incompetent tricuspid valve and closure of the atrial septal defect led to significant improvement. The diagnostic usefulness of radionuclide imaging and echocardiography is demonstrated in this case. A mechanism of right to left interatrial shunting in the presence of normal pulmonary arterial pressures is proposed; this invokes phasic increases in right atrial pressure from tricuspid insufficiency and streaming of blood from the inferior vena cava into the left atrium across a patent foramen ovale in a manner that resembles conditions in the fetal circulation.

Original languageEnglish (US)
Pages (from-to)1401-1406
Number of pages6
JournalThe American Journal of Cardiology
Volume44
Issue number7
DOIs
StatePublished - Jan 1 1979

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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