{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T02:08:03Z","timestamp":1758334083309,"version":"3.44.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T00:00:00Z","timestamp":1755388800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Traumatic mitral regurgitation (MR) is an exceptionally rare complication associated with blunt chest trauma, particularly following relatively low-impact injuries. In the critical and chaotic settings of polytrauma, its diagnosis is often delayed and can easily be overlooked. This oversight can lead to progressive haemodynamic deterioration and, ultimately, fatal outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 73-year-old man sustained blunt chest trauma after falling \u223c2.5\u2005m from a truck bed. Initial assessment revealed a left haemopneumothorax and multiple rib fractures, with no audible heart murmur or signs of haemodynamic compromise. A chest drain was inserted, and he was discharged after conservative management. However, 3\u2005weeks post-injury, a Grade III systolic regurgitant murmur was newly detected. Transthoracic and transoesophageal echocardiography revealed severe eccentric MR due to posterior mitral valve prolapse caused by chordal rupture. Intraoperative inspection confirmed a P2 chordal rupture with myxomatous degeneration. The patient underwent successful mitral valve repair and had an uneventful postoperative recovery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case highlights that traumatic MR, though extremely rare, can occur even after relatively minor trauma in elderly individuals, potentially due to underlying degenerative changes. Clinical signs of acute MR can be obscured by coexisting injuries, and auscultatory findings may only become apparent after these conditions have been treated. While echocardiography is crucial for identifying traumatic valvular dysfunction, its effectiveness can be limited by various factors associated with polytrauma. Therefore, a high index of suspicion is essential to prevent overlooking this potentially life-threatening complication in cases of blunt chest trauma.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf399","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T11:53:03Z","timestamp":1755172383000},"source":"Crossref","is-referenced-by-count":0,"title":["\u2018Whisper from the mitral valve\u2019: delayed diagnosis of traumatic mitral valve regurgitation in an elderly farmer\u2014a case report"],"prefix":"10.1093","volume":"9","author":[{"given":"Shinnosuke","family":"Tsukamoto","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Centre , 2002-7, Isou, Hikami-cho, Tamba, Hyogo 669-3495 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6764-6293","authenticated-orcid":false,"given":"Kensuke","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Centre , 2002-7, Isou, Hikami-cho, Tamba, Hyogo 669-3495 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Centre , 2002-7, Isou, Hikami-cho, Tamba, Hyogo 669-3495 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akitaka","family":"Yamada","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Kita-Harima Medical Centre , 926-250, Ichibacho, Ono, Hyogo 675-1392 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Tamba Medical Centre , 2002-7, Isou, Hikami-cho, Tamba, Hyogo 669-3495 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,16]]},"reference":[{"key":"2025091917340272000_ytaf399-B1","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1161\/01.CIR.18.3.371","article-title":"Nonpenetrating traumatic injury of the heart","volume":"18","author":"Parmley","year":"1958","journal-title":"Circulation"},{"key":"2025091917340272000_ytaf399-B2","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/0002-8703(73)90349-9","article-title":"Nonpenetrating cardiac injuries: a collective review","volume":"86","author":"Liedtke","year":"1973","journal-title":"Am Heart J"},{"key":"2025091917340272000_ytaf399-B3","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/S0003-4975(99)01343-0","article-title":"Mitral and tricuspid valve rupture after moderate blunt chest trauma","volume":"69","author":"Bailey","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"2025091917340272000_ytaf399-B4","first-page":"486","article-title":"Insuficiencia mitral por rotura aislada de m\u00fasculo papilar secundaria a traumatismo tor\u00e1cico cerrado [Mitral insufficiency caused by isolated rupture of the papillary muscle secondary to blunt thoracic trauma]","volume":"48","author":"Prieto Sol\u00eds","year":"1995","journal-title":"Rev Esp Cardiol"},{"key":"2025091917340272000_ytaf399-B5","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S1010-7940(01)00727-8","article-title":"Papillary muscle rupture and pericardial injuries after blunt chest trauma","volume":"20","author":"Bruschi","year":"2001","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025091917340272000_ytaf399-B6","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/BF02098782","article-title":"Traumatic rupture of the anterior papillary muscle. 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