Abstract
:This case study concerns a patient with disruption of both tricuspid and aortic valves: a previously healthy, adult man, who sustained a 5-meter fall from a building under construction. The mechanism of the injury was acceleration and deceleration, acting in two different phases of the cardiac cycle, i.e. systole and diastole. Simultaneous occurrence of these injuries is exceedingly rare and in a careful literature review, we did not find any such combination of injury. The possible mechanisms of this injury, as well as surgical techniques are discussed.
Highlights
One of the most common injuries after blunt chest trauma is myocardial contusion,[1] which itself is probably under-diagnosed
After a careful literature review, we discovered that this is probably the first single case report of simultaneous injury of both aortic and tricuspid valves that was associated with falling from height
The mechanism causing aortic valve rupture is considered to be a sudden increase in intra-aortic pressure during a vulnerable phase of the cardiac cycle, especially during diastole, when the aortic valve is closed and the trans-aortic gradient is maximal.[6]
Summary
One of the most common injuries after blunt chest trauma is myocardial contusion,[1] which itself is probably under-diagnosed. Septal and free-wall ruptures of all four chambers have been well described in postmortem series.[2] Right ventricle is the most commonly ruptured chamber in closed-chest trauma and coronary artery disruption is rare.[2] Further, postmortem series and the clinical literature suggest that acute valvular dysfunction after chest trauma is very rare. Especially involving fall from a multi floor building, can result in serious multi organ injuries. It is proposed that the underlying mechanism cause to these injuries requires a high amount of inertia released by the above mechanism in a fall from a high building. 3 We report a case of rupture of both tricuspid and aortic valves in a previously healthy 34-year-old man who fell from a height of 5 meters and sustained blunt chest trauma It is proposed that the underlying mechanism cause to these injuries requires a high amount of inertia released by the above mechanism in a fall from a high building. 3 We report a case of rupture of both tricuspid and aortic valves in a previously healthy 34-year-old man who fell from a height of 5 meters and sustained blunt chest trauma
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