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{{Infobox_Disease |
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{{Tricuspid regurgitation}}
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  DiseasesDB    = 13348 |
  ICD10          = {{ICD10|I|07|1|i|05}}, {{ICD10|I|36|1|i|30}} |
  ICD9          = {{ICD9|397.0}} |
  ICDO          = |
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  MeshID        = D014262 |
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{{SK}} Tricuspid insufficiency, TR, primary tricuspid regurgitation, organic tricuspid regurgitation, secondary tricuspid regurgitation, functional tricuspid regurgitation


==Overview==
==[[Tricuspid regurgitation overview|Overview]]==


'''Tricuspid insufficiency''', a [[valvular heart disease]] also called '''Tricuspid regurgitation''', refers to the failure of the heart's [[tricuspid valve]] to close properly during [[systole]]. As a result, with each heart beat, a portion of the blood is pumped out from the right side of the heart backwards in the ''opposite'' direction into the [[right atrium]] rather than forwards into the [[right ventricle]].
==[[Tricuspid regurgitation classification|Classification]]==


==Causes==
==[[Tricuspid regurgitation pathophysiology|Pathophysiology]]==


Although congenital causes of [[tricuspid insufficiency]] exist, most cases are due to dilation of the [[right ventricle]]. Such dilation leads to derangement of the normal anatomy and mechanics of the [[tricuspid valve]] and the muscles governing its proper function. The result is incompetence of the tricuspid valve. Common causes of right ventricular dilation include left [[heart failure]], [[pulmonary hypertension]], and right ventricular [[infarction]]. One notable exception to right ventricular dilation as a cause of tricuspid insufficiency occurs in right-sided [[endocarditis]] (i.e. infection affecting the right side of the heart). In that case, there is direct damage to the tricuspid valve as as a  result of infection.
==[[Tricuspid regurgitation causes|Causes]]==


==Diagnosis==
==[[Tricuspid regurgitation differential diagnosis|Differential Diagnosis]]==
===Symptoms===
Tricuspid insufficiency may be asymptomatic, especially if right ventricular function is well preserved. Conversely, [[edema]], vague upper abdominal discomfort (from a congested liver), and fatigue (due to diminished [[cardiac output]]) can all be present to some degree.


===Physical examination===
==[[Tricuspid regurgitation epidemiology and demographics|Epidemiology and Demographics]]==
On examination, the [[jugular venous pressure]] is usually elevated, and 'CV' waves can be seen. The liver may be enlarged and is often pulsatile (the latter finding being virtually diagnostic of tricuspid insufficiency). Peripheral edema is often found. In severe cases, there may be [[ascites]] and even [[cirrhosis]] (so-called 'cardiac cirrhosis).


[[Tricuspid insufficiency]] may lead to the presence of a pansystolic [[heart murmur]]. Such a murmur is usually of low frequency and best heard low on the left sternal border. It tends to increase with inspiration. However, the murmur may be inaudible reflecting the relatively low pressures in the right side of the heart. A third heart sound may also be present.
==[[Tricuspid regurgitation natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


===Echocardiography===
==Diagnosis==
The diagnosis is usually confirmed on echocardiography if a pulsatile liver and/or the presence of prominent CV waves in the jugular pulse is noted on physical examination.
[[Tricuspid regurgitation stages|Stages]] | [[Tricuspid regurgitation symptoms|History and Symptoms]] | [[Tricuspid regurgitation physical examination|Physical examination]] | [[Tricuspid regurgitation echocardiography|Echocardiography]] | [[Tricuspid regurgitation chest x ray|Chest X Ray]] | [[Tricuspid regurgitation electrocardiogram|Electrocardiography]] | [[Tricuspid regurgitation cardiac stress test|Cardiac Stress Test]] | [[Tricuspid regurgitation cardiac MRI|Cardiac MRI]] | [[Tricuspid regurgitation cardiac catheterization|Cardiac Catheterization]]


==Therapy==
==Treatment==
In most cases, surgery is not indicated since the root problem lies with a dilated or damaged [[right ventricle]]. Medical therapy with [[diuretics]] is the mainstay of treatment. Unfortunately, this can lead to volume depletion and decreased [[cardiac output]]. Indeed, one must often accept a certain degree of symptomatic tricuspid insufficiency in order to prevent a decrease in cardiac output. Treatment with medicines to reduce cardiac [[afterload]] may also be of benefit but a similar risk of depressed cardiac output applies.
[[Tricuspid regurgitation medical therapy|Medical therapy]] | [[Tricuspid regurgitation surgery|Surgery]]


{{Circulatory system pathology}}
{{Circulatory system pathology}}
[[Category: Valvular heart disease]]
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[[Category:Cardiology]]


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Latest revision as of 15:35, 3 May 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2], Fatimo Biobaku M.B.B.S [3] Vamsikrishna Gunnam M.B.B.S [4]

Synonyms and keywords: Tricuspid insufficiency, TR, primary tricuspid regurgitation, organic tricuspid regurgitation, secondary tricuspid regurgitation, functional tricuspid regurgitation

Overview

Classification

Pathophysiology

Causes

Differential Diagnosis

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

Stages | History and Symptoms | Physical examination | Echocardiography | Chest X Ray | Electrocardiography | Cardiac Stress Test | Cardiac MRI | Cardiac Catheterization

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Medical therapy | Surgery


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