16 August 2026
: Case report 
Severe Tricuspid Regurgitation: Traumatic Papillary Muscle Rupture Mimicking Infective Endocarditis—A Case Report
Challenging differential diagnosis, Management of emergency care, Rare disease
Soichiro Kobayashi E 1,2, Taku Omori
E 1*, Daisuke Izumi E 2,3, Toshiya Tokui E 4, Atsunobu Kasai E 2, Kaoru Dohi E 1
DOI: 10.12659/AJCR.952267
Am J Case Rep 2026; 27:e952267
Table 1 Transthoracic echocardiographic findings.
| Parameter | Finding | Units |
|---|---|---|
| Aortic diameter | 34.0 | mm |
| Left ventricular outflow tract | 21.8 | mm |
| Left atrial diameter | 47.0 | mm |
| Interventricular septal thickness | 9.5 | mm |
| Posterior wall thickness | 10.0 | mm |
| Left ventricular diastolic diameter | 56.0 | mm |
| Left ventricular systolic diameter | 48.0 | mm |
| End-diastolic volume (m-Simpson) | 118.0 | mL |
| End-systolic volume (m-Simpson) | 78.0 | mL |
| Left ventricular ejection fraction (m-Simpson) | 34.0 | % |
| Hate rate | 98 | beats/min |
| Inferior vena cava diameter | 19 | mm |
| Early diastolic mitral inflow velocity | 36.0 | cm/s |
| Ratio of early to late mitral inflow | 0.41 | |
| Deceleration time of E wave | 155 | ms |
| Early diastolic mitral annular velocity (average) | 6.4 | cm/s |
| Ratio of E to average E′ | 5.9 | |
| Right ventricular diastolic (base) | 37.1 | mm |
| Right ventricular diastolic (mid) | 29.4 | mm |
| Right ventricular diastolic (long) | 83.6 | mm |
| Tricuspid annular plane systolic excursion | 17.4 | mm |
| Right ventricular fractional area change | 47 | % |
| Vena contracta width of TR | 8.3 | mm |
| Color Doppler jet area of TR | 14.7 | cm |
| Color Doppler jet area of TR to right atrial area ratio | 68 | % |
| Abbreviations: IE, infective endocarditis; TR, tricuspid regurgitation; m-Simpson = modified Simpson method; E, early transmitral inflow velocity; E′, average early diastolic mitral annular velocity. | ||