Persistent Hypoxia After Blunt Thoracic Trauma due to Flail Tricuspid Valve Leaflet and Patent Foramen Ovale

Am Surg. 2023 Nov;89(11):4992-4995. doi: 10.1177/00031348221148357. Epub 2022 Dec 26.

Abstract

Structural cardiac injury after blunt trauma is uncommon but usually life-threatening. While tricuspid injury is very rare and potentially lethal, the right heart can accommodate larger volumes and higher pressures in acute tricuspid insufficiency and facilitate initial stabilization prior to definitive valvular repair. ECMO may be used to ameliorate resulting right heart failure. The traumatic force required to cause cardiac structural injury is also associated with pulmonary complications related to pneumothorax, hemothorax, effusion, acute pain secondary to rib fractures, and pulmonary contusions causing hypoxia. We present an unusual case of hypoxia in a trauma patient caused by acute tricuspid regurgitation with pre-existing patent foramen ovale.

Keywords: Trauma; blunt thoracic trauma; cardiac trauma; extra corporeal membrane oxygenation; tricuspid valve injury.

Publication types

  • Case Reports

MeSH terms

  • Foramen Ovale, Patent* / complications
  • Foramen Ovale, Patent* / diagnostic imaging
  • Heart Injuries* / complications
  • Heart Injuries* / diagnostic imaging
  • Humans
  • Hypoxia / complications
  • Tricuspid Valve / diagnostic imaging
  • Tricuspid Valve / injuries
  • Tricuspid Valve Insufficiency* / diagnostic imaging
  • Tricuspid Valve Insufficiency* / etiology
  • Wounds, Nonpenetrating* / complications