Latent Avulsion of the Posterior Mitral Leaflet Base from the Mitral Annulus following a Motor Vehicle Accident: A Case Report

Reza Mohseni Badalabadi; Parto Siavosh; Hakimeh Sadeghian

doi:10.18502/jthc.v17i2.9845

Reza Mohseni Badalabadi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Parto Siavosh Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Hakimeh Sadeghian Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v17i2.9845

Keywords: Mitral valve insufficiency; Thoracic injuries; Myocardial contusions

Abstract

Injuries to the heart and great vessels should always be considered after blunt chest trauma. Valvular damage rarely occurs after blunt trauma, but symptoms may be delayed. A 58-year-old woman was referred to our hospital with exertional dyspnea (functional class III) and palpitations for elective transesophageal echocardiography. Her symptoms had exacerbated in the preceding 2 or 3 months. Physical examination showed holosystolic murmurs (IV/VI) at the lower sternal border with extension to the apex. Transesophageal echocardiography revealed avulsion of the base of the posterior mitral valve leaflet (P3) from the annulus. In the past medical history, there was a history of a motor vehicle accident 9 months earlier. The patient was recommended for mitral valve surgery. Mitral valve replacement was performed, and the diagnosis was confirmed by surgery. The patient was discharged without any complications.