Case report: flail tricuspid valve as a rare complication of blunt chest trauma

Blunt chest trauma-induced tricuspid valve flail represents a rare and potentially serious complication. Its clinical manifestation can vary from acute and severe to subclinical and chronic, ultimately culminating in right heart failure. We report a case of a flail tricuspid valve identified several years following blunt chest trauma.

A 39-year-old man was admitted to the hospital due to progressive dyspnoea and palpitations persisting for 2 years. He had a history of blunt chest trauma a decade prior. The electrocardiogram showed atrial flutter. The echocardiography revealed severe tricuspid regurgitation secondary to a flail tricuspid valve; additionally, dilation of the right ventricle with reduced function was evident. Cardiac computed tomography (CT) showed dilation of the right heart. In the right heart catheterization, pulmonary artery pressure was not increased. Surgical intervention for the tricuspid valve was recommended.

This case highlights the severe tricuspid regurgitation resulting from non-penetrating thoracic trauma-induced flail. Focused on imaging diagnosis and clinical course. Echocardiography was decisive in the structural and functional evaluation of tricuspid pathology and the evaluation of right ventricular function. Additionally, cardiac computed tomography provided complementary information about the dimensions of the right heart chambers. In patients with primary tricuspid regurgitation, right heart dilation, and right ventricular systolic dysfunction, surgical management is recommended.