Tricuspid regurgitation causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]

Overview

Most cases of significant tricuspid regurgitation are due to tricuspid annular dilation and leaflet tethering secondary to right ventricular remodeling from volume and/or pressure overload.[1] Such dilation leads to derangement of the normal anatomy and mechanics of the tricuspid valve and the muscles governing its proper function. The result is incompetence of the tricuspid valve. Common causes of right ventricular dilation include left heart failure, pulmonary hypertension, and right ventricular infarction. One notable exception to right ventricular dilation as a cause of tricuspid insufficiency occurs in right-sided endocarditis where direct damage to the tricuspid valve occurs.

Causes

Primary Tricuspid Regurgitation

Some of the causes of direct valve injury resulting in primary TR are:[1]

  • Radiation
  • Chest wall trauma

Secondary Tricuspid Regurgitation

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.


Causes by Organ System

Cardiovascular Acute coronary syndrome, anomalous pulmonary venous return, atrial fibrillation, atrial septal defect, cardiac sarcoidosis, congenital heart disease, congestive heart failure, coronary artery disease, dilated cardiomyopathy, Ebstein's anomaly, Eisenmenger syndrome, endomyocardial fibrosis, infective endocarditis, ischemic heart disease, left heart failure, Marantic endocarditis, mitral annular calcification, mitral regurgitation, mitral stenosis, myocardial rupture, papillary muscle rupture, pulmonary atresia, pulmonary regurgitation, pulmonary stenosis, restrictive cardiomyopathy, rheumatic heart disease, right ventricular dilation, right ventricular tumors, Takotsubo cardiomyopathy, tetralogy of Fallot, transposition of the great arteries, truncus arteriosus, ventricular septal defect
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Cabergoline, dexfenfluramine, ergotamine, fenfluramine, fluoxetine, indomethacin, methysergide, paroxetine, pergolide, phentermine, sertraline
Ear Nose Throat No underlying causes
Endocrine Carcinoid syndrome, hyperthyroidism
Environmental No underlying causes
Gastroenterologic Primary intestinal lymphangiectasia, protein-losing gastroenteropathy
Genetic Aneuploidy, congenital nephrotic syndrome, Downs syndrome, Ehlers-Danlos syndrome, Holt-Oram syndrome, Marfan's syndrome, osteogenesis imperfecta, polycystic kidney disease, Turner syndrome, X-linked dilated cardiomyopathy
Hematologic No underlying causes
Iatrogenic Acute cardiac allograft rejection, balloon valvuloplasty of the tricuspid valve, cardiac catheterization, cardiac transplant, cardiopulmonary resuscitation, cathether ablation for arrhythmias, endomyocardial biopsy, heart surgery, implantable cardioverter-defibrillator, pacemaker syndrome, percutaneous coronary intervention, permanent pacemaker, postpericardiotomy syndrome, prosthetic valve dysfunction, pulmonary artery catheterization
Infectious Disease Chagas disease, HIV, infective endocarditis, myocarditis, rheumatic fever
Musculoskeletal/Orthopedic Ehlers-Danlos syndrome, Marfan's syndrome, osteogenesis imperfecta
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Peripartum cardiomyopathy, twin-to-twin transfusion syndrome
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric Takotsubo cardiomyopathy
Pulmonary Cor pulmonale, interstitial lung disease, Loefflers syndrome, pulmonary embolism, pulmonary hypertension, pulmonary veno-occlusive disease
Renal/Electrolyte Congenital nephrotic syndrome, end stage renal disease, polycystic kidney disease
Rheumatology/Immunology/Allergy Cardiac sarcoidosis, Ehlers-Danlos syndrome, Marfan's syndrome, osteogenesis imperfecta, rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis
Sexual No underlying causes
Trauma Blunt or penetrating chest trauma
Urologic No underlying causes
Miscellaneous Functional tricuspid regurgitation

Causes in Alphabetical Order

References

  1. ↑ 1.0 1.1 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: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 63 (22): e57–185. doi:10.1016/j.jacc.2014.02.536. PMID pmid24603191 Check |pmid= value (help).
  2. ↑ 2.0 2.1 2.2 Pereira S, Ganapathy R, Syngelaki A, Maiz N, Nicolaides KH (2011). "Contribution of fetal tricuspid regurgitation in first-trimester screening for major cardiac defects". Obstet Gynecol. 117 (6): 1384–91. doi:10.1097/AOG.0b013e31821aa720. PMID 21606749.
  3. ↑ Kikuchi C, Motohashi S, Takahashi Y, Nakazawa S, Kanazawa H (2013). "A successful treatment for concomitant injury of the coronary artery and tricuspid valve after blunt chest trauma". Gen Thorac Cardiovasc Surg. doi:10.1007/s11748-013-0322-5. PMID 24043608.
  4. ↑ Bhattacharyya S, Schapira AH, Mikhailidis DP, Davar J (2009). "Drug-induced fibrotic valvular heart disease". Lancet. 374 (9689): 577–85. doi:10.1016/S0140-6736(09)60252-X. PMID 19683643.
  5. ↑ Goyal SB, Aragam JR (2006). "Cardiac sarcoidosis with primary involvement of the tricuspid valve". Cardiol Rev. 14 (5): e12–3. doi:10.1097/01.crd.0000181620.57608.09. PMID 16924157.
  6. ↑ Malaki M, Ghaffari S, Ghaffari S, Rastkar B, Goldust M, Malaki P; et al. (2011). "Cardiac findings in congenital nephrotic syndrome". J Cardiovasc Thorac Res. 3 (3): 83–5. doi:10.5681/jcvtr.2011.018. PMID 24250960.
  7. ↑ Cirit M, Ozkahya M, Cinar CS, Ok E, Aydin S, Akçiçek F; et al. (1998). "Disappearance of mitral and tricuspid regurgitation in haemodialysis patients after ultrafiltration". Nephrol Dial Transplant. 13 (2): 389–92. PMID 9509451 PMID 9509451 Check |pmid= value (help).
  8. ↑ Acquatella H, Schiller NB, Puigbó JJ, Gómez-Mancebo JR, Suarez C, Acquatella G (1983). "Value of two-dimensional echocardiography in endomyocardial disease with and without eosinophilia. A clinical and pathologic study". Circulation. 67 (6): 1219–26. PMID 6851016.
  9. ↑ Hendrikx M, Van Dorpe J, Flameng W, Daenen W (1996). "Aortic and mitral valve disease induced by ergotamine therapy for migraine: a case report and review of the literature". J Heart Valve Dis. 5 (2): 235–7. PMID 8665020.
  10. ↑ Wilke A, Hesse H, Hufnagel G, Maisch B (1997). "Mitral, aortic and tricuspid valvular heart disease associated with ergotamine therapy for migraine". Eur Heart J. 18 (4): 701. PMID 9129909.
  11. ↑ Sagie A, Schwammenthal E, Padial LR, Vazquez de Prada JA, Weyman AE, Levine RA (1994). "Determinants of functional tricuspid regurgitation in incomplete tricuspid valve closure: Doppler color flow study of 109 patients". J Am Coll Cardiol. 24 (2): 446–53. PMID 8034882.
  12. ↑ Silva-Cardoso J, Moura B, Ferreira A, Martins L, Bravo-Faria D, Mota-Miranda A; et al. (1998). "Predictors of myocardial dysfunction in human immunodeficiency virus-infected patients". J Card Fail. 4 (1): 19–26. PMID 9573500.
  13. ↑ Paladini D, Tiesi M, Buffi D, Tuo G, Marasini M (2013). "Unexplained right atrial enlargement may be a sign of Holt-Oram syndrome in the fetus". Ultrasound Obstet Gynecol. doi:10.1002/uog.13238. PMID 24185902.
  14. ↑ Plastiras SC, Economopoulos N, Kelekis NL, Tzelepis GE (2006). "Magnetic resonance imaging of the heart in a patient with hypereosinophilic syndrome". Am J Med. 119 (2): 130–2. doi:10.1016/j.amjmed.2005.10.055. PMID 16443414.
  15. ↑ Bana DS, MacNeal PS, LeCompte PM, Shah Y, Graham JR (1974). "Cardiac murmurs and endocardial fibrosis associated with methysergide therapy". Am Heart J. 88 (5): 640–55. PMID 4420941.
  16. ↑ Movahed MR, Saito Y, Ahmadi-Kashani M, Ebrahimi R (2007). "Mitral annulus calcification is associated with valvular and cardiac structural abnormalities". Cardiovasc Ultrasound. 5: 14. doi:10.1186/1476-7120-5-14. PMC 1838405. PMID 17359540.
  17. ↑ Pritchett AM, Morrison JF, Edwards WD, Schaff HV, Connolly HM, Espinosa RE (2002). "Valvular heart disease in patients taking pergolide". Mayo Clin Proc. 77 (12): 1280–6. doi:10.4065/77.12.1280. PMID 12479512.
  18. ↑ Wilkinson P, Pinto B, Senior JR (1965). "Reversible protein-losing enteropathy with intestinal lymphangiectasia secondary to chronic constrictive pericarditis". N Engl J Med. 273 (22): 1178–81. doi:10.1056/NEJM196511252732202. PMID 5847556.
  19. ↑ Meadows J, Jenkins K (2011). "Protein-losing enteropathy: integrating a new disease paradigm into recommendations for prevention and treatment". Cardiol Young. 21 (4): 363–77. doi:10.1017/S1047951111000102. PMID 21349233.
  20. ↑ Zheng DW, Shao GF, Feng Q, Ni YM (2013). "Long-term outcome of correction of tetralogy of Fallot in 56 adult patients". Chin Med J (Engl). 126 (19): 3675–9. PMID 24112162.
  21. ↑ Zosmer N, Bajoria R, Weiner E, Rigby M, Vaughan J, Fisk NM (1994). "Clinical and echographic features of in utero cardiac dysfunction in the recipient twin in twin-twin transfusion syndrome". Br Heart J. 72 (1): 74–9. PMC 1025429. PMID 8068474.

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