[Mitral valve incompetence after blunt chest trauma. Case report and review of the literature in special consideration of legal medical opinions]

Abstract

Background: Blunt thoracic trauma may lead to cardiac lesions including cardiac valve dysfunctions. In these cases, mitral valve is quite often involved. Preexisting mitral valve disease, especially the prolapse syndrome, has to be differentiated from trauma-induced dysfunction. This differentiation may be important for delivering an official legal medical opinion.

Case report and review of the literature: The authors report on a patient, presenting with acute severe mitral valve insufficiency 4 months after blunt chest trauma due to a motor vehicle accident. After a review of the literature concepts to differentiate trauma-induced mitral valve dysfunction from preexisting valve disease are discussed in special consideration of aspects of official legal medical opinions.

Conclusion: To get complete information on the initial cardiac status at the time of chest trauma, detailed echocardiographic evaluation is necessary independent of the severity or mechanism of trauma. If valve surgery is required, macroscopic valve description and microscopic diagnosis are important to clarify the etiology of valve dysfunction. This diagnostic evaluation allows to assess the causality between trauma and valve dysfunction in most of the cases.