Introduction 
Car accidents induced blunt chest trauma can cause many cardiac complications such as right ventricular free-wall rupture, tricuspid valve rupture, tricuspid valve regurgitation, ventricular septal rupture,  coronary artery dissection or thrombosis, left ventriclular chordae and papillary muscle rupture, heart failure and arrhythmias1-3. One of the most common valvular complication is tricuspid regurgitation (TR)4, which can be diagnosed by transthoracic echocardiography (TTE) acutely and followed by TTE for sequelue during follow-up5.
Unlike rupture of cardiac wall or left sided valves, tricuspid valve rupture usually does not result in immediate hemodynamic instability and may go undiagnosed5,6. TR after chest-wall trauma may involve any part of valvular apparatus5,7 and depending upon the severity of the structural damage to the tricuspid apparatus, the manifestations can vary. Herein we present the case of a car driver who sustained blunt chest-wall trauma and then developed TR due to tricuspid valve leaflet perforation and subsequently another TR jet from tricuspid annular dilation due to right ventricle remodeling during long term follow up.