Tricuspid stenosis physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
Normally, tricuspid stenosis co-exists with mitral stenosis, thus depending on the severity of mitral valve pathology, symptoms differ. Patients can lay flat without symptoms in absence of serious mitral valve pathology. | Normally, tricuspid stenosis co-exists with [[mitral stenosis]], thus depending on the severity of mitral valve pathology, symptoms differ. Patients can lay flat without symptoms in absence of serious mitral valve pathology and not present with signs of [[dyspnea]]. | ||
===Neck=== | ===Neck=== | ||
Revision as of 20:17, 22 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Physical Examination
Normally, tricuspid stenosis co-exists with mitral stenosis, thus depending on the severity of mitral valve pathology, symptoms differ. Patients can lay flat without symptoms in absence of serious mitral valve pathology and not present with signs of dyspnea.
Neck
- An elevated jugular venous pulse may be present.
- "a wave" is prominent but in presence of atrial fibrillation, "a wave" is lost.
- "y" descent is slow.
Heart
Palpation
- Patients with tricuspid stenosis may feature a prominent right atrium palpable to the right of the sternum.
Auscultation
Heart Sounds
- A tricuspid opening snap may be heard if it is not obscured by the sounds of mitral stenosis.
- First heart sound, S1 may be widely fixed.
- Second heart sound, S2 may be single.
Murmurs
- Its a mid diastolic murmur.
- It is caused by the blood flow through the stenotic valve .
- It is best heard over the left sternal border with rumbling character and tricuspid opening snap with wide splitting of S1.
- The murmur of tricuspid stenosis may increase in intensity with inspiration (Carvallo's sign), leg raising and squatting.
- Tricuspid regurgitation oftentimes presents in a similar location, delineated by a holosystolic murmur.
Abdominal
- Patients frequently experience peripheral edema, hepatomegaly and ascites.