Tricuspid regurgitation classification: Difference between revisions
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The stages of TR can be estimated based on specific criteria for the valve anatomy, valve hemodynamics, associated cardiac findings, and symptoms. | The stages of TR can be estimated based on specific criteria for the valve anatomy, valve hemodynamics, associated cardiac findings, and symptoms. | ||
'''2014 AHA/ACC Guidelines for Valvular Heart Diseases'''<ref name="pmid24589852">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. | journal=Circulation | year= 2014 | volume= | issue= | pages= | pmid=24589852 | doi=10.1161/CIR.0000000000000029 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24589852 }} </ref> | '''2014 AHA/ACC Guidelines for Valvular Heart Diseases'''<ref name="pmid24589852">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. | journal=Circulation | year= 2014 | volume= | issue= | pages= | pmid=24589852 | doi=10.1161/CIR.0000000000000029 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24589852 }} </ref><ref name="pmid28298458">{{cite journal |vauthors=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM, Thompson A |title=2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines |journal=Circulation |volume=135 |issue=25 |pages=e1159–e1195 |date=June 2017 |pmid=28298458 |doi=10.1161/CIR.0000000000000503 |url=}}</ref> | ||
<span style="font-size:85%">'''Abbreviations:''' '''CW:''' continuous wave; '''ICD:''' [[implantable cardioverter-defibrillator]]; '''IE:''' [[infective endocarditis]]; '''IVC:''' [[inferior vena cava]]; '''RA:''' [[right atrium]]; '''RV:''' [[right ventricle]]; '''TR:''' [[tricuspid regurgitation]]</span> | <span style="font-size:85%">'''Abbreviations:''' '''CW:''' continuous wave; '''ICD:''' [[implantable cardioverter-defibrillator]]; '''IE:''' [[infective endocarditis]]; '''IVC:''' [[inferior vena cava]]; '''RA:''' [[right atrium]]; '''RV:''' [[right ventricle]]; '''TR:''' [[tricuspid regurgitation]]</span> |
Revision as of 18:22, 2 March 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]
Overview
Tricuspid regurgitation (TR) can be broadly classified as primary or secondary. Primary (or organic) TR results from an organic lesion of the tricuspid valve itself, whereas secondary (or functional) TR is caused by left heart failure or pulmonary hypertension without an intrinsic abnormality of the tricuspid valve.
Classification
The stages of TR can be estimated based on specific criteria for the valve anatomy, valve hemodynamics, associated cardiac findings, and symptoms.
2014 AHA/ACC Guidelines for Valvular Heart Diseases[1][2]
Abbreviations: CW: continuous wave; ICD: implantable cardioverter-defibrillator; IE: infective endocarditis; IVC: inferior vena cava; RA: right atrium; RV: right ventricle; TR: tricuspid regurgitation
Stage | Definition | Valve anatomy | Valve hemodynamics | Hemodynamic consequences | Symptoms of TR, left heart failure, or pulmonary vascular disease |
---|---|---|---|---|---|
A | At risk of TR | Primary
Secondary
|
Absent or trace TR | Absent | Absent |
B | Progressive TR | Primary
Secondary
|
Mild TR
Moderate TR
|
Mild TR
Moderate TR |
Absent |
C | Asymptomatic severe TR | Primary
Secondary
|
* Central jet area >10.0 cm
2* Vena contracta width >0.7 cm
|
* Dilated RV/RA/IVC and decreased IVC respirophasic variation
|
Absent |
D | Symptomatic severe TR | Primary
Secondary
|
* Central jet area >10.0 cm2
|
* Dilated RV/RA/IVC and decreased IVC respirophasic variation
|
Presence of symptoms (fatigue, dyspnea, anorexia, edema, abdominal distention, palpitations) |
References
- ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0000000000000029. PMID 24589852.
- ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM, Thompson A (June 2017). "2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". Circulation. 135 (25): e1159–e1195. doi:10.1161/CIR.0000000000000503. PMID 28298458.