Categories: Cardiology

Tricuspid Regurgitation (Tricuspid Valve Insufficiency)

If you are up to this topic I assume that you are well aware of the heart and its role as a vital organ that pushes blood all through the body and collects back deoxygenated blood returning from body. The heart has 4 chambers 2 upper atrium and 2 bottom ventricles. The atrium and ventricles are separated by valves, which provide unidirectional blood flow. Left ventricle opens in aorta that supplies oxygenated blood to the body via other arteries.

  • Left ventricle and aorta are separated by an Aortic Valve.
  • The left atrium and left ventricle are separated by mitral valve
  • Right atrium and right ventricle are separated by tricuspid valve
  • A valve between the right ventricle and the pulmonary artery is called pulmonary valve

Each valve has three cusps except mitral valve which has two cusps.

What is Tricuspid Regurgitation?

When the tricuspid valve leaks or does not close properly a small volume of blood regurgitates back, this is known as Tricuspid Valve Insufficiency or Tricuspid Regurgitation.

Signs and Symptoms

  • Swollen abdomen
  • reduced urine production
  • swelling of foot and ankle
  • fatigue or general weakness due to a reason unknown
  • arrhythmia or irregular heartbeat
  • swelling in the body
  • palpitation in neck vein

Causes

  1. Dilation of right ventricle-As we have already mentioned right ventricle takes deoxygenated blood through the pulmonary artery to the lungs. In certain conditions (like emphysema, pulmonary hypertension, heart disorders, pulmonic stenosis) ventricles need to work harder than normal due to which it is hypertrophied. This eventually led to Tricuspid Valve Insufficiency.
  2. Certain Medicines like fenfluramine and phentermine
  3. Infections of the valves like infective endocarditis
  4. Others like
  5. Autoimmune disorders like systemic lupus
  6. Rheumatic fever
  1. Carcinoid tumors
  2. Birth defects pertaining to valve
  3. Ebstein’s anomaly (a birth defect)
  • Marfan’s syndrome
  • Tricuspid valve prolapse
  1. Myxomatous degeneration

Diagnosis

  • Verbal questions
  • Physical Examination with a stethoscope- Abnormal heart sounds are heard at a stethoscope examination. This is presented as a heart murmur
  • Electrocardiogram
  • Chest X-Ray
  • Echocardiogram
  • Transesophageal echocardiogram
  • Cardiac catheterization
  • Radionuclide scan
  • MRI

Treatment

More often than not it does not require any treatment at all, even though the following management options can be followed if the problem is severe

  • Medication management
  1. Management of high blood pressure
  2. Diuretics, or water pills
  • Lifestyle Management
  1. Exercises like low-intensity cardio activities like walking
  2. Quit smoking
  • Lower body weight, maintain it
  1. Diet for High blood pressure with low sodium
  • Surgical options for valve replacement include:
  1. Mechanical valve — a long-lasting valve made of durable materials
  2. Tissue valve (which may include human or animal donor tissue) last 10-20 years
  • Ross Procedure — “Borrowing” your healthy valve and moving it into the position of the damaged valve aortic valve
  1. Newer surgery options like donor valve implantation- Human donor valves, only used in conditions like infective endocarditis
  • Regular check-up with your clinician

Possible complications

Apart from the cases which do not require any management, if untreated it may result in complications like

  • Heart Failure
  • Weight loss
  • Loss of appetite
  • Liver Cirrhosis
  • Endocarditis

Prevention

  • Excellent care of teeth and gums needs to be taken
  • Prophylactic and intervening antibiotics during any surgical procedure
  • Any kind of infection in the body (as small as a sore throat) should be reported and taken care of.

Tricuspid regurgitation is not severe and may not even interfere with any part of your daily living. Now you know what precautions need to be taken and when to take it forward. Stay aware, stay healthy…

Dr. Anand Kumar Pandey, Director & Senior Consultant – Cardiology, Dharamshila Narayana Superspeciality Hospital, Delhi

Narayana Health

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