Acute Severe Mitral Regurgitation due to Papillary Muscle Rupture after Blunt Chest Trauma: Case Report

Document Type : Case Report


Thoracic Surgeon, Cardiothoracic Surgery Department, Faculty of Medicine, Minia University, Egypt. Madinah Cardiac Center, King Fahad Hospital, Madinah, KSA.


Cardiac injury is a common unexpected injury with high rate of mortality in multi-trauma patients. Blunt thoracic trauma leading to heart injury presented with variable presentations from myocardial contusion to rupture.  Cardiac injury is about 15% - 25% of blunt chest trauma. Cardiac contusion is the most common type of injury with variable manifestations associated with electrocardiogram (ECG) changes or cardiac enzyme abnormality.  Traumatic rupture of intra-cardiac structures after blunt Thoracic trauma is an uncommon. Cardiac valves rupture is uncommon, and the most frequent being aortic valve, and then followed by mitral and tricuspid. Nowadays, the incidence of these types of injury is increasing due to high increase of road traffic accidents (RTA).   Following blunt thoracic trauma, rupture of papillary muscle or its chordae tendineae is a very rare causing acute mitral regurgitation (MR) with sequence of congestive heart failure (HF) and pulmonary edema.  


  1. Cresce GD, Favaro A, D’Onofrio A, Piccin C, Magagna P, Spanghero M, et al. Post-Traumatic Rupture of the Anterolateral Papillary Muscle. Ann Thorac Surg. 2009; 88: 1664 - 6.
  2. Bernabeu E, Mestres CA, Osorio PL, Josa M. Case report – Valves Acute aortic and mitral valve regurgitation following blunt chest trauma. Interact Cardiovasc Thorac Surg. 2004; 3: 198–200.
  3. Simmers T, Meijburg HW, De la Riviere AB. Traumatic Papillary Muscle Rupture. Ann Thorac Surg. 2001; 71: 257–9.
  4. Halstead J, Hosseinpour AR, Wells Conservative Surgical Treatment of Valvular Injury after Blunt Chest Trauma. Ann Thorac Surg. 2000; 69: 766–68.
  5. McLaughlin JS, Cowley RA, Smith G, Matheson NA. Mitral valve disease from blunt trauma. J Thorac Cardiovasc Surg. 1964; 48: 261–71.
  6. Petteys S, Roark S, Kunz J, Atwood J, Thurber J, Hnatiuk O. Case Reports: Acute Onset Hemoptysis Caused by Mitral Valve Rupture During a Sports Injury. Chest. 2011; 140. doi:10.1378/chest.1119898.
  7. Beigoli S, Sharifi Rad A, Askari A, Assaran Darban R, Chamani J. Isothermal titration calorimetry and stopped flow circular dichroism investigations of the interaction between lomefloxacin and human serum albumin in the presence of amino acids J Biomol Struct Dyn. 2019; 37(9):2265-2282.
  8. Chamani J, Moosavi-Movahedi AA. Effect of n-alkyl trimethylammonium bromides on folding and stability of alkaline and acid-denatured cytochrome c: A spectroscopic approach. J Colloid Interf Sci. 2006; 297(2):561-569.
  9. Choi JS, Kim EJ. Simultaneous Rupture of the Mitral and Tricuspid Valves with Left Ventricular Rupture Caused by Blunt Trauma. Ann Thorac Surg. 2008; 86: 1371–73.
  10. Shaikh N, Ummunissa F, Abdel-Sattar M. Case Report Traumatic Mitral Valve and Pericardial Injury. Case Reports in Critical Care. 2013.
  11. Yang S, Wang C, Chen H. Case report Partial aortic annulus avulsion and formation of aortic-left ventricle tunnel through interventricular septum after blunt cardiac trauma. Euro J Cardiothorac Surg. 2011; 40; 255-56.
  12. Kumagai H,, Hamanaka Y, Hirai S, Mitsui N, Kobayashi Mitral Valve Plasty for Mitral Regurgitation after Blunt Chest Trauma. Ann Thorac Cardiovasc Surg. 2001; 7 (3): 175-79.