Tricuspid regurgitation history and symptoms: Difference between revisions
Rim Halaby (talk | contribs) |
Rim Halaby (talk | contribs) |
||
| Line 7: | Line 7: | ||
==History== | ==History== | ||
Patients with suspected or diagnosed TR should be inquired about symptoms related to [[right heart failure]] in order to assess the clinical severity of TR. | Patients with suspected or diagnosed TR should be inquired about symptoms related to [[right heart failure]] in order to assess the clinical severity of TR. Pediatric patients should be assessed for growth and development in order to evaluate whether TR is associated with [[failure to thrive]].<ref name="pmid20813320">{{cite journal| author=Anyanwu AC, Adams DH| title=Functional tricuspid regurgitation in mitral valve disease: epidemiology and prognostic implications. | journal=Semin Thorac Cardiovasc Surg | year= 2010 | volume= 22 | issue= 1 | pages= 69-75 | pmid=20813320 | doi=10.1053/j.semtcvs.2010.05.006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20813320 }} </ref> | ||
Patients should also be asked about symptoms or known history of possible causes of primary TR: | Patients should also be asked about symptoms or known history of possible causes of primary TR: | ||
| Line 17: | Line 17: | ||
* [[Trauma]] to the [[chest]] | * [[Trauma]] to the [[chest]] | ||
* [[Carcinoid syndrome]] | * [[Carcinoid syndrome]] | ||
* [[Radiation]] | |||
In addition, patients should be asked about symptoms and possible causes of [[left heart failure]] and [[pulmonary hypertension]], which are the most common causes of secondary TR. When the patient is asked about left heart failure, it is optimal to obtain details about the following: | In addition, patients should be asked about symptoms and possible causes of [[left heart failure]] and [[pulmonary hypertension]], which are the most common causes of secondary TR. When the patient is asked about left heart failure, it is optimal to obtain details about the following: | ||
Revision as of 23:18, 10 September 2014
|
Tricuspid Regurgitation Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Tricuspid regurgitation history and symptoms On the Web |
|
American Roentgen Ray Society Images of Tricuspid regurgitation history and symptoms |
|
Risk calculators and risk factors for Tricuspid regurgitation history and symptoms |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
The history of a patient with suspected or confirmed tricuspid regurgitation (TR) should include information about the possible etiologies of primary and secondary TR. TR occurs most commonly secondary to pulmonary hypertension and left heart failure; therefore, detailed information about these conditions should be obtained. The majority of TR are asymptomatic. Symptoms of TR include clinical manifestations related to right heart failure such as peripheral edema and abdominal distention. If left heart failure or pulmonary hypertension is the underlying etiology of TR, the patient might have symptoms related to these conditions.
History
Patients with suspected or diagnosed TR should be inquired about symptoms related to right heart failure in order to assess the clinical severity of TR. Pediatric patients should be assessed for growth and development in order to evaluate whether TR is associated with failure to thrive.[1]
Patients should also be asked about symptoms or known history of possible causes of primary TR:
- Rheumatic heart disease
- Myxomatous changes
- Endocarditis
- Presence of a pacemaker
- Recent endomyocardial biopsy
- Trauma to the chest
- Carcinoid syndrome
- Radiation
In addition, patients should be asked about symptoms and possible causes of left heart failure and pulmonary hypertension, which are the most common causes of secondary TR. When the patient is asked about left heart failure, it is optimal to obtain details about the following:
- Arrhythmia
- Cardiomyopathies
- Cardiotoxins e.g., alcohol, cocaine
- Congenital heart disease
- Hypertension
- Ischemic heart disease
When the patient is asked about pulmonary hypertension, it is optimal to obtain details about the following:
- History of exposure to cocaine, methamphetamine, alcohol leading to cirrhosis, and smoking leading to emphysema
- Hepatic disease, congenital heart disease, thyroid diseases, and diseases that cause hypoxia
- Snoring and daytime sleepiness to rule out obstructive sleep apnea (OSA)
- Skin changes, Raynaud's phenomenon and joint pain suggestive of connective tissue disorder
- History of deep vein thrombosis or pulmonary embolism
- Over-the-counter medications and herbal supplements as well as illicit drug use
- High risk for HIV exposure
- Family history of pulmonary hypertension
Symptoms
Symptoms Related to Right Heart Failure
- Abdominal distention
- Peripheral edema
- Palpitations (atrial fibrillation occurs due to the dilatation of the right atrium)[2]
Symptoms Related to Left Heart Failure
- Fatigue (due to the decrease in cardiac output)
- Decreased exercise tolerance
Symptoms Related to Pulmonary Hypertension
- Dyspnea
- Fatigue
- Raynaud's phenomenon
- Syncope
- Chest pain
- Near Syncope
- Palpitations
- Leg swelling
- Cough (rare)
- Hemoptysis (rare)
- Hoarseness (rare)
References
- ↑ Anyanwu AC, Adams DH (2010). "Functional tricuspid regurgitation in mitral valve disease: epidemiology and prognostic implications". Semin Thorac Cardiovasc Surg. 22 (1): 69–75. doi:10.1053/j.semtcvs.2010.05.006. PMID 20813320.
- ↑ Bruce CJ, Connolly HM (2009). "Right-sided valve disease deserves a little more respect". Circulation. 119 (20): 2726–34. doi:10.1161/CIRCULATIONAHA.108.776021. PMID 19470901.