[Isolated tricuspid insufficiency of traumatic type. Report of a case and revision of the literature (author's transl)].

A case of isolated tricuspid insufficiency is reported. The lesion, that at surgery resulted to be an anterior valve leaflet detachment, was well tolerated for a long time. After 23 years from the trauma the patient was successfully treated by surgical correction. The clinical features, compared to the 33 cases reported in the literature, demonstrated that the clinical course was more dramatic in patients with papillary muscle rupture than in those where the lesion was located on the chordae tendineae and/or the valves. The physical findings are characteristic but not specific of the traumatic type of tricuspidal insufficiency. However, when these symptoms are found in a patient where a trauma has previously occurred, the correct diagnosis should consider this possibility. The ECG usually shows incomplete bundle branch block, and the chest roentgenogram reveals cardiomegaly. Furthermore, the blood pressure levels in the right chambers are nearly normal. Surgery is often indicated and seems to give very good results. Our patient markedly improved after surgical treatment. Electrocardiographic and vectorcardiographic evidence of right atrial and ventricular hypertrophy was reduced as well as the roentgenographic pattern.