Tricuspid stenosis causes

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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]

Overview

The most common cause of tricuspid stenosis is rheumatic heart disease. Other causes of tricuspid stenosis include carcinoid syndrome, congenital abnormalities, endocarditis, lupus, and mechanical obstruction by a tumor.

Causes

Common Causes

  • Rheumatic heart disease is one of the most common causes of TS and almost always occurs in conjunction with mitral stenosis.[1][2][3]
  • Large vegetations in infective endocarditis can cause relative stenosis.
  • Carcinoid syndrome may cause isolated TS or mixed with the regurgitant lesion[4].
  • Systemic diseases like systemic lupus erythematosus (SLE), antiphospholipid antibody (APLA) syndrome and the presence of permanent pacing and fusion of implantable cardioverter defibrillator leads to sub-valvular structures can cause tricuspid stenosis[5][6].
  • Benign tumors like atrial myxomas can cause functional TS[7].
  • Blunt trauma has also been described as a risk factor. Renal and ovarian tumors can grow into the tricuspid orifice causing stenosis.

Less Common Causes

  • Other less common causes of TS include congenital abnormalities (Ebstein’s anomaly)[8], metabolic or enzymatic abnormalities (Fabry’s disease, Whipple’s disease)[3].
  • Sometimes described are intravenous leiomyomatosis[9], ventriculoatrial shunts causing TS[10].
  • Valvulopathy associated with drugs like fenfluramine/phentermine and methysergide is characterized by thickened fibrotic and hypomobile tricuspid leaflets, with various degrees of valve stenosis and regurgitation[11].

Causes by Organ System

Cardiovascular Congenital heart disease, cardiac tumor, saphenous vein bypass graft aneurysm,[12] Ebstein's anomaly, endomyocardial fibrosis, infective endocarditis, myxoma, rheumatic heart disease
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Methysergide
Ear Nose Throat No underlying causes
Endocrine Carcinoid syndrome
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic Pacemaker infection, pacemaker leads[13], device closure of right coronary arteriovenous fistula.[14]
Infectious Disease Infective endocarditis
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Fabry disease, Whipple's disease
Obstetric/Gynecologic No underlying causes
Oncologic Carcinoid syndrome, cardiac tumor, intravenous leiomyomatous tumor,[9] metastatic tumor, myxoma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Amyloidosis,[15] systemic lupus erythematosus
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Giant blood cyst

Causes by Alphabetical Order

References

  1. Roberts WC, Ko JM (July 2008). "Some observations on mitral and aortic valve disease". Proc (Bayl Univ Med Cent). 21 (3): 282–99. doi:10.1080/08998280.2008.11928412. PMC 2446420. PMID 18628928.
  2. Baumgartner H, Hung J, Bermejo J, Chambers JB, Evangelista A, Griffin BP; et al. (2009). "Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice". Eur J Echocardiogr. 10 (1): 1–25. doi:10.1093/ejechocard/jen303. PMID 19065003.
  3. 3.0 3.1 Waller BF, Howard J, Fess S (1995). "Pathology of tricuspid valve stenosis and pure tricuspid regurgitation--Part I." Clin Cardiol. 18 (2): 97–102. PMID 7720297.
  4. Pellikka PA, Tajik AJ, Khandheria BK, Seward JB, Callahan JA, Pitot HC, Kvols LK (April 1993). "Carcinoid heart disease. Clinical and echocardiographic spectrum in 74 patients". Circulation. 87 (4): 1188–96. doi:10.1161/01.cir.87.4.1188. PMID 7681733.
  5. Gur AK, Odabasi D, Kunt AG, Kunt AS (July 2014). "Isolated tricuspid valve repair for Libman-Sacks endocarditis". Echocardiography. 31 (6): E166–8. doi:10.1111/echo.12558. PMID 24661289.
  6. Al-Hijji M, Yoon Park J, El Sabbagh A, Amin M, Maleszewski JJ, Borgeson DD (August 2015). "The Forgotten Valve: Isolated Severe Tricuspid Valve Stenosis". Circulation. 132 (7): e123–5. doi:10.1161/CIRCULATIONAHA.115.016315. PMID 26283605.
  7. Şaşkın H, Düzyol Ç, Özcan KS, Aksoy R (August 2015). "Right atrial myxoma mimicking tricuspid stenosis". BMJ Case Rep. 2015. doi:10.1136/bcr-2015-210818. PMC 4550937. PMID 26272962.
  8. Khatib N, Blumenfeld Z, Bronshtein M (November 2012). "Early prenatal diagnosis of tricuspid stenosis". Am. J. Obstet. Gynecol. 207 (5): e6–8. doi:10.1016/j.ajog.2012.08.030. PMID 22964066.
  9. 9.0 9.1 9.2 Nili M, Liban E, Levy MJ (June 1982). "Tricuspid stenosis due to intravenous leiomyomatosis--a call for caution: case report and review of the literature". Tex Heart Inst J. 9 (2): 231–5. PMC 351617. PMID 15226964.
  10. Akram Q, Saravanan D, Levy R (April 2011). "Valvuloplasty for tricuspid stenosis caused by a ventriculoatrial shunt". Catheter Cardiovasc Interv. 77 (5): 722–5. doi:10.1002/ccd.22745. PMID 20824751.
  11. Muraru D, Badano LP, Sarais C, Soldà E, Iliceto S (June 2011). "Evaluation of tricuspid valve morphology and function by transthoracic three-dimensional echocardiography". Curr Cardiol Rep. 13 (3): 242–9. doi:10.1007/s11886-011-0176-3. PMID 21365261.
  12. Jellis CL, Navia JL, Flamm SD, Rodriguez LL (2016). "Severe Functional Tricuspid Stenosis Secondary to a Giant Saphenous Vein Bypass Graft Aneurysm". Circulation. 133 (21): 2099–102. doi:10.1161/CIRCULATIONAHA.115.014772. PMID 27217436 PMID: 27217436 Check |pmid= value (help).
  13. Taira K, Suzuki A, Fujino A, Watanabe T, Ogyu A, Ashikawa K (2006). "Tricuspid valve stenosis related to subvalvular adhesion of pacemaker lead: a case report". J Cardiol. 47 (6): 301–6. PMID 16800373.
  14. Changchien C, Lin MT, Wang CC, Liu HM, Wang CC, Chiu SN; et al. (2015). "Neonatal tricuspid stenosis caused by device closure of a large coronary fistula". EuroIntervention. 11 (7): e1. doi:10.4244/EIJV11I7A162. PMID 26603866 PMID: 26603866 Check |pmid= value (help).
  15. 15.0 15.1 Kim KH, Park CH, Park HS, Kim YR, Choi EY (2014). "Amyloidosis-induced tricuspid stenosis mimicking rheumatic heart disease". Eur Heart J Cardiovasc Imaging. 15 (10): 1167. doi:10.1093/ehjci/jeu075. PMID 24797117.

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