Conclusion
A detailed history taking is always important to solve a medical puzzle. The etiology of the case would have been overlooked had it not been for the history of blunt trauma two years prior to presentation. We should also keep in mind the fact that traumatic AR can present late and these patients can rarely remain asymptomatic. In patients with severe AR, without any evidence of rheumatic heart disease, endocarditis or a bicuspid valve and with an AR jet though a leaflet should raise the suspicion of traumatic AR. TEE is mandatory and diagnostic as it readily confirms the pathology. Surgical management should be the general approach with valve replacement being the standard treatment of choice.
Conflict of interest: None