Tricuspid stenosis echocardiography
|
Tricuspid stenosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Tricuspid stenosis echocardiography On the Web |
|
American Roentgen Ray Society Images of Tricuspid stenosis echocardiography |
|
Risk calculators and risk factors for Tricuspid stenosis echocardiography |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Transthoracic echocardiography (TTE) should be performed in a patient with suspected tricuspid stenois to confirm the diagnosis, determine the etiology, and establish the baseline severity. Echocardiography is useful for the assessment of the function of the right ventricle prior to surgery.
Echocardiography
2D-Echocardiography
2D-echocardiography is useful to identify the following:
- Thickening of valve leaflets
- Calcification
- restricted mobility
- " Doming " of the leaflets
Doppler Echocardiography
Doppler echocardiography is useful to assess the severity of tricuspid stenosis through the evaluation of the transvalvular gradient.
- Using continuous wave doppler across the tricuspid valve in apical-4-chamber view, the peak gradient can be calculated using the modified Bernoulli equation.
- Pressure half time can be used but is not validated for triscuspid stenosis.
- Calculation of tricuspid valve area with the continuity equation
Tricuspid valve area = ( annulus PW Vti * Cross sectional area of the annulus) / valve CW Vti
Assessment of Tricuspid Stenosis Severity with Echocardiography
TTE findings that are associated with increased severity of tricuspid stenosis include:
- Valve thickening and calcification
- Chordal thickening and calcification
- Mean pressure gradient >5 mm Hg,
- Pressure half-time >190 milliseconds
- Tricuspid valve area < 1.0 cm2
- Enlargement of the right atrium
- Enlargement of the inferior vena cava
| Severity | mild | moderate | severe |
|---|---|---|---|
| Tricuspid valve area | - | - | <1 |
| Mean Pressure Gradient | <4 | 4-7 | >7 |
Differential Diagnosis of a Tricuspid Mass Causing Obstruction
- Right atrial tumor
- Right atrial ball valve thrombus
- Large vegetations
2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary[1]
| Class I |
| "1. TTE is indicated in patients with TS to assess the anatomy of the valve complex, evaluate severity of stenosis, and characterize any associated regurgitation and/or left-sided valve disease. (Level of Evidence: C)" |
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.