[Traumatic tricuspid insufficiency with right-left atrial shunt].

A particular form of traumatic tricuspid incompetence with a right-to-left interatrial shunt through a patent foramen ovale is reported. This case and six similar previously published reports have the following features in common: clinically, tricuspid incompetence is associated with cyanosis and raised jugular venous pressure, pulsatile hepatomegaly and a systolic murmur in the subxiphoid region in about haĺf the cases. The ECG showed incomplete or complete right bundle branch block in six of the seven cases, associated with left anterior hemiblock in four cases. The right cardiac chambers were dilated in all cases. Diagnosis may be confirmed by cardiac catheterisation and selective angiocardiography. The outcome and tolerance of the condition depend on the underlying tricuspid lesions. Papillary muscle rupture imposes early surgical intervention. Rupture or elongation of the chordae is compatible with good tolerance over a number of years.