Severe tricuspid regurgitation after a horse kick: a case report of a rare cause of acquired valvulopathy

Many rare complications are associated with blunt chest trauma and right ventricular contusion. Among these, post-traumatic severe tricuspid regurgitation is a relatively rare clinical entity. Furthermore, only a few cases reported in the literature are associated with trauma due to kicking by a horse.

We present the case of a 56-year-old woman who was diagnosed with early massive tricuspid regurgitation caused by traumatic rupture of the anterior papillary muscle, which was successfully treated by surgical tricuspid repair. The patient had no symptoms suggestive of valvular dysfunction, which was incidentally detected on routine transthoracic echocardiogram following a horse kick.

The most commonly cited mechanism is an anteroposterior compression of the chest, causing a sudden increase in right ventricular pressure during the end-diastolic phase. The mean interval to diagnosis of traumatic tricuspid regurgitation is usually long, leading to a progressive right ventricular remodelling and deterioration of right ventricular function. As a result, surgical repair of the valve is often not possible and an early tricuspid valve replacement is required.