This case report describes a patient who developed symptoms of dyspnoea early after a high velocity car accident. Her symptoms were progressive and 25 days after the trauma massive aortic insufficiency was diagnosed. Operation showed a tear in the commissure between the right and the non-coronary cusps with a tear in the intima. Uncomplicated aortic valve replacement followed. Traumatic aortic insufficiency is a rare and sometimes difficult diagnosis to make. Clinical presentation, pathophysiology, diagnosis and treatment are described.
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