Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Tricuspid valve regurgitation (TR)Tricuspid valve insufficiency (TI) ++ 397.0 Diseases of tricuspid valve ++ I07.1 Rheumatic tricuspid insufficiencyI36.1 Nonrheumatic tricuspid (valve) insufficiency ++ 6D: Impaired aerobic capacity/endurance associated with cardiovascular pump dysfunction or failure1 +++ Description ++ Tricuspid valve does not close properly during systoleCauses a backflow and fluid overload in the right atriumFluid overload in the right atrium can lead to weakening of the right atrial wallUsually asymptomaticIrregular heart beat +++ Essentials of Diagnosis ++ Stethoscope for auscultation of a pansystolic heart murmur at lower left sternal borderEchocardiographyEKG/ECGCT/MRI for enlargement of the right side of the heartCardiac catheterizationChest x-rayExercise stress test +++ General Considerations ++ Signs and symptoms should be monitoredMild to moderate regurgitation generally does not cause symptoms.Symptoms often weakness and fatiguePatients can develop bacterial endocarditis +++ Demographics ++ Seen in individuals with Ebstein’s anomaly (congenital heart disease) ++ Jugular venous distensionWeaknessFatigueEndocarditisCirrhosisWeight lossSwellingAbdomenLiverSpleenPeripheral edemaFeetAnklesDecreased urine outputHeart murmur ++ Symptoms depend on degree of valvular dysfunctionMild to moderate regurgitation generally does not cause symptomsSevere regurgitation causes fatigue, weakness, and signs of congestive heart failurePatients may be unaware of their reduced cardiovascular capacityCan cause syncope, chest pain, and heart failure if untreated ++ Tricuspid valve prolapseEnlargement of the right ventricleRight ventricular infarctionInferior myocardial infarctionCor pulmonaleInfective endocarditisDrug abuseDiet medication: phentermine and fenfluramineBacteria in the blood streamPulmonary hypertensionEbstein’s anomaly (congenital heart disease)Marfan syndromeRheumatoid arthritisRheumatic feverSystemic lupus erythematosus ++ Acute coronary syndromeAortic regurgitationAortic stenosisMitral valve prolapseMitral stenosisMyocardial infarction complicationShock, hypovolemiaCardiac pump dysfunctionCardiac muscle dysfunctionCardiac pump failure +++ Imaging ++ Echocardiography to measure blood pressure inside the heart and lungsMRI of the heartChest x-rayEnlarged left atriumEnlarged left ventricleEKG +++ Diagnostic Procedures ++ Cardiac catheterizationAssessment of coronary artery disease, EF, pulmonary artery wedge pressurePhonocardiogram ++ Elevated jugular venous pressureBackflow of blood into left atrium during systoleLeft ventricular dysfunctionPossible increase in left pulmonary venous pressurePansystolic murmur at the lower left sternal border +++ Medication ++ Medications for heart failure induced by tricuspid regurgitation:DiureticsBeta-blockersPositive inotropic agentsAngiotensin-converting enzymeAldosterone antagonistsAntibiotics for patients with a history of rheumatic feverVasodilators like nitroprusside and hydralazine to decrease afterloadInpatient pharmacologic management +++ Medical Procedures ++ Internal cardiac defibrillatorTricuspid valve replacement/repairCardiac resynchronizationCoronary artery bypassLeft or right ventricular ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.