Tricuspid regurgitation caused by blunt chest trauma is generally quite tolerable for a long time in a clinical setting. This article reports on a 68-year-old patient suffering from progressive dyspnea after a blunt chest trauma having occurred 5 months previously. Flu-like symptoms occurred for several days before severe respiratory distress began upon the day of admission. Transesophageal echocardiographic evidence of endocarditis and right-to-left shunt across a patent foramen ovale (PFO) was demonstrated. Traumatic tricuspid insufficiency in this case was complicated with infective endocarditis and right-to-left intracardiac shunt. Cyanotic congestive heart failure occurred suddenly. He underwent emergency surgical repair with success. Based on the results presented herein, we recommend that early diagnosis be made for traumatic regurgitation and endocarditis by echocardiography so as to ensure therapeutic intervention.