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VOLUME 25 , ISSUE 6 ( June, 2021 ) > List of Articles


A Child with Unilateral Pulmonary Edema due to Mitral Valve Rupture Following Blunt Trauma

Satarupa Mukherjee, Krupanandan Ravikumar, Sudeep K Kapalavai

Citation Information : Mukherjee S, Ravikumar K, Kapalavai SK. A Child with Unilateral Pulmonary Edema due to Mitral Valve Rupture Following Blunt Trauma. Indian J Crit Care Med 2021; 25 (6):729-731.

DOI: 10.5005/jp-journals-10071-23859

License: CC BY-NC 4.0

Published Online: 01-06-2021

Copyright Statement:  Copyright © 2021; The Author(s).


A 7-year-old boy was admitted with a history of cough and tachypnea for 1 day. There was a history of a fall from a motorcycle with some abrasions over the left arm. The child was found to have tachypnea and tachycardia and was started on noninvasive ventilation. Auscultation revealed a pansystolic murmur over the precordium. Chest X-ray revealed unilateral pulmonary edema on the right side. Echocardiography showed severe mitral regurgitation (MR) with the tear of the anterior leaflet. The child improved with diuretics and supportive care. After 3 months, he underwent surgical repair of the mitral valve. Traumatic mitral valve tear is quite rare in children. Unilateral pulmonary edema is a feature of MR with eccentric jet and is frequently misinterpreted.

  1. Mattox KL, Flint LM, Carrico CJ, Grover F, Meredith J, Morris J, et al. Blunt cardiac injury. J Trauma Inj Inf Crit Care 1992;33(5):649–650. DOI: 10.1097/00005373-199211000-00001.
  2. Parmley LF, Mattingly TW. Non-penetrating traumatic injury of the heart. Circulation 1958;18:371–396. DOI: 10.1161/01.cir.18.3.371.
  3. Maenza RL, Seaberg D, D’Amico F. A meta-analysis of blunt cardiac trauma: ending myocardial confusion. Am J Emerg Med 1996;14(3):237–241. DOI: 10.1016/s0735-6757(96)90165-5.
  4. Pasquier M, Sierro C, Yersin B, Delay D, Carron P-N. Traumatic mitral valve injury after blunt chest trauma: a case report and review of the literature. J Trauma Inj Inf Crit Care 2010;6(1):243–246. DOI: 10.1097/ta.0b013e3181bb881e.
  5. McCrory D, Craig B, O’Kane H. Traumatic mitral valve rupture in a child. Ann Thorac Surg 1991;51(5):821–822. DOI: 10.1016/0003-4975(91)90138-g.
  6. Golbasi Z, Cicek D, Ucar O, Kaya D, Keles T, Cicekcioglu H, Aydogdu S. Traumatic ventricular septal defect and mitral insufficiency after a Kebab's Shish wound to the chest. Eur J Echocardiogr 2001;2:203–204. DOI: 10.1053/euje.2001.0074.
  7. Hazan E, Guzeloglu M, Sariosmanoglu N, Ugurlu B, Keskin V, Unal N. Repair of isolated mitral papillary muscle rupture consequent to blunt trauma in a small child. Tex Heart Inst J 2009;36(3):252–254.
  8. Forteleoni A, Montereggi F, Sanna GD, Portoghese M, Parodi G. Traumatic mitral valve regurgitation: a case report and state-of-the-art review. J Cardiovasc Med 2019;20(10):709–717. DOI: 10.2459/jcm.0000000000000809.
  9. Karalis DG, Victor MF, Davis GA, McAllister MPJ, Covalesky VA, Ross JJ, et al. The role of echocardiography in blunt chest trauma: a transthoracic and transesophageal echocardiographic study. J Trauma 1994;36:53–58. DOI: 10.1097/00005373-199401000-00008.
  10. Selzer A, Kelly JJ, Vannitamby M, Walker P, Gerbode F, Kerth WJ. The syndrome of mitral insufficiency due to isolated rupture of the chordae tendineae. Am J Med 1967;43(6):822–836. DOI: 10.1016/0002-9343(67)90241-0.
  11. Audenaert SM. Unilateral pulmonary edema in children. Clin Pediat 2016;32:363–365. DOI: 10.1177/000992289303200609.
  12. Goff NW, Weese WC. A case of unilateral neurogenic pulmonary edema. Ariz Med 1981;38:832–833.
  13. Schnyder PA, Sarraj AM, Duvoisin BE, Kapenberger L, Landry MJ. Pulmonary edema associated with mitral regurgitation: prevalence of predominant involvement of the right upper lobe. AJR Am J Roentgenol 1993;161:33–36. DOI: 10.2214/ajr.161.1.8517316.
  14. Miyatake K, Nimura Y, Sakakibara H, Kinoshita N, Okamoto M, Nagata S, et al. Localisation and direction of mitral regurgitant flow in mitral orifice studied with combined use of ultrasonic pulsed Doppler technique and two dimensional echocardiography. Br Heart J 1982:48:449–458. DOI: 10.1136/hrt.48.5.449.
  15. Roach JM, Stajduhar KC, Torrington KG. Right upper lobe pulmonary edema caused by acute mitral regurgitation. Diagnosis by transesophageal echocardiography. Chest 1993;103:1286–1288. DOI: 10.1378/chest.103.4.1286.
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