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Heart, section through the middle
Heart, section through the middle


Heart, front view
Heart, front view


Tricuspid Regurgitation
Tricuspid Regurgitation


Tricuspid Regurgitation
Tricuspid Regurgitation


Definition:

Tricuspid regurgitation is a disorder in which the heart's tricuspid valve does not close properly, causing blood to flow backward (leak) into the right upper heart chamber (atrium) when the right lower heart chamber (ventricle) contracts.



Alternative Names:

Tricuspid insufficiency



Causes, incidence, and risk factors:

The tricuspid valve separates the right lower heart chamber (the right ventricle) from the right upper heart chamber (right atrium).

The most common cause of tricuspid regurgitation is swelling of the right ventricle. Such swelling may be a complication of any disorder that causes failure of the right ventricle.

Other diseases can directly affect the tricuspid valve. The most common of these is rheumatic fever , which is a complication of untreated strep throat infections.

Tricuspid regurgitation affects about 4 out of 100,000 people. It may be found in those with a type of congenital heart disease called Ebstein's anomaly .

Other infrequent causes of tricuspid regurgitation include:

  • Carcinoid tumors, which release a hormone which damages the valve
  • Marfan syndrome
  • Injury
  • Rheumatoid arthritis
  • Radiation therapy

Another important risk factor for tricuspid regurgitation is use of the diet medications called "Fen-Phen" (phentermine and fenfluramine) or dexfenfluramine.



Symptoms:

Tricuspid regurgitation may not cause any symptoms if the patient does not have pulmonary hypertension . If pulmonary hypertension and moderate-to-severe tricuspid regurgitation exist together, the following symptoms may result:



Signs and tests:

The health care provider may detect abnormalities when when gently pressing with the hand (palpating ) on your chest. The doctor may also feel a pulse over your liver. The physical exam may reveal liver and spleen swelling.

Listening to the heart with a stethoscope shows a murmur or abnormal sounds.There may be signs of fluid collection in the abdomen.

An ECG or echocardiogram may show swelling of the right side of the heart. Doppler echocardiography or right-sided cardiac catheterization are used to measure blood pressures inside the heart and lung.



Treatment:

Treatment may not be needed if there are few or no symptoms. Hospitalization may be required for diagnosis and treatment of severe symptoms. Underlying disorders should be identified and treated. Some people may be able to have surgery to repair or replace the tricuspid valve.



Support Groups:



Expectations (prognosis):

Treatment of any underlying conditions, especially high blood pressure in the lungs and swelling of the right lower heart chamber, may correct the disorder. Surgical valve repair or replacement usually provides a cure. However, persons with severe tricuspid regurgitation that cannot be corrected may have a poor prognosis.



Complications:

Calling your health care provider:

Call your health care provider if symptoms of tricuspid regurgitation are present.



Prevention:

Prompt treatment of disorders that can cause valve disease reduces your risk of tricuspid regurgitation. Treat strep infections promptly to prevent rheumatic fever.

Any invasive procedure, including dental work and cleaning, can introduce bacteria into your bloodstream. The bacteria can infect a damaged mitral valve, causing endocarditis. Always tell your health care provider and dentist if you have a history of heart valve disease or congenital heart disease before treatment. Taking antibiotics before dental or other invasive procedures may decrease your risk of endocarditis.



References: Karchmer AW. Infectious Endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007: Chap. 63.


Review Date: 5/12/2008
Reviewed By: Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, and Private practice specializing in Cardiovascular Disease, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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