Banu GÖKÇEN, Aydın ŞANLI, Ahmet ÖNEN, VOLKAN KARAÇAM, Taha OKAN, Ünal AÇIKEL

Künt toraks travması sonrası gelişen akut mitral yetmezliği

Kunt toraks travmasına bağlı olarak gelişen kardiak yaralanmalar sonucu nadir olarak valvüler lezyonlar ortaya çıkabilmektedir. Acil serviste araç içi trafik kazası nedeniyle değerlendirilen 20 yaşındaki erkek olgunun fizik muayenesinde mitral odakta üfürüm, akciğer kontüzyonu ve şüpheli kot fraktürü saptandı. Daha önceden kardiyak rahatsızlığı ve efor kapasitesinde kısıtlılığı olmadığını ifade eden olguya elektif şartlarda ekokardiyografi (EKO) yapıldı ve posterior leaflet flail görünümde, posterior leafieti tutan kordal yapılarda rüptür ve mitral yetmezlik jetinin tüm sol atriumu doldurmakta olduğu tesbit edilerek ağır mitral yetmezliği (MY) tanısı kondu. Genel durumu iyi olan ve kardiyak yetmezlik bulguları olmayan olgunun medikal tedavisi düzenlenerek servis izlemine alındı. Elektif şartlarda operasyon önerildi. Kunt toraks travması ile acil serviste değerlendirilen hastaların kardiyak travmaya açık hastalar olduğu unutulmamalı, dikkatli ve tam fizik muayene yapılmalıdır.

Anahtar Kelimeler:

Toraks yaralanmaları, Kazalar, trafik, Yaralar, delici olmayan, Ekokardiyografi, Erkek, Erişkin, Akut hastalık, Mitral kapak yetmezliği

Acute mitral insuffiency due to blunt chest trauma

Valvüler lesions may be observed due to cardiac injuries after blunt thoracic traumas. A 20 year —old male patient admitted to the emergency department after a car accident. His physical examination reveled a pansystolic murmur at mitral area by auscultation. On his chest X-ray examination, it was found out that pulmonary contusion and a suspected rib fracture were present. This patient didn't declare any prior cardiac illness and exertional dsypnea. Echocardiographic examination was carried out under elective circumstances. This examination defined a flail-like appearance at the posterior leaflet of the mitral valve, rupture of the chordae holding mitral posterior leaflet and severe mitral regurgitation. His general condition was fine and he is given medical treatment at our clinic, and elective mitral valvüler surgery has been proposed. The patients admitted to the emergency department because of blunt chest trauma should be carefully examined.

Keywords:

Thoracic Injuries, Accidents, Traffic, Wounds, Nonpenetrating, Echocardiography, Male, Adult, Acute Disease, Mitral Valve Insufficiency,

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