1-3),5),12) In some cases, delayed tricuspid regurgitation after blunt chest trauma was reported.7)10) So, if patient has late presentation of clinical signs and symptoms, physicians should consider repeated imaging. Transthoracic echocardiography is often difficult to be Obeticholic Acid ic50 performed in some patients with blunt chest trauma because of coexisting chest injuries. In that case, transesophageal echocardiography can safely provide more information of cardiac anatomy involved in traumatic tricuspid regurgitation.7),10) So physicians should consider transesophageal echocardiography if transthoracic echocardiography is inconclusive or cardiac injury is strongly suspicious. In our case,

transthoracic echocardiography was enough to know injured

Inhibitors,research,lifescience,medical tricuspid valvular anatomy, Inhibitors,research,lifescience,medical but we performed transesophageal echocardiography to get more information. This case highlights that physicians should be aware of cardiac complications following blunt chest trauma and using echocardiography as initial examination tools. Although many patients tolerate well many years after the onset of traumatic tricuspid regurgitation, the earlier diagnosis and surgical intervention provide not only prevention of right ventricular deterioration but also feasibility of tricuspid valve repair. We report a case in which Inhibitors,research,lifescience,medical echocardiography was performed as initial screening tool for a young patient presented with chest and abdominal pain after blunt chest trauma, so we could diagnose traumatic tricuspid regurgitation early after admission and performed valve repair operation successfully before right ventricular deterioration.
A healthy 59-year-old man was first admitted with acute

bacterial meningitis [cerebrospinal fluid (CSF) : WBC, 3,750/uL Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical (polymorphonuclear neutrophil 97%); glucose, 33 mg/dL; protein, 151 mg/dL]. Cultures of both blood and CSF were positive for S. pneumoniae. On the fifth day of intravenous cephalosporin with relieving symptoms as fever and headache, the patient suddenly complained foot dropping. Brain magnetic imaging (MRI) showed multiple cerebral infarctions in both high frontal lobes (Fig. 1). A transthoracic echocardiography (TTE) to evaluate cardioembolic source revealed no abnormal finding except for mild prolaptic motion of non-coronary cusp (NCC) of aortic valve (AV) with trivial aortic regurgitation (AR) Cytidine deaminase (Fig. 2). After 2-week course of antibiotic therapy and conservative care, the patient was discharged with symptom improvement. Fig. 1 Brain magnetic resonance imaging at the first admission with pneumococcal meningitis shows the multiple cerebral infarctions in both high frontal lobes. Fig. 2 Transthoracic echocardiogram at the first admission with pneumococcal meningitis shows a prolaptic motion of non-coronary cusp (A) with trivial aortic regurgitation (B). After 4 months, the patient revisited our hospital with exertional dyspnea for 3 weeks.