Tricuspid regurgitation history and symptoms

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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 history of a patient with suspected or confirmed tricuspid regurgitation (TR) should include information about the possible etiologies of primary and secondary TR. TR occurs most commonly secondary to pulmonary hypertension and left heart failure; therefore, detailed information about these conditions should be obtained. The majority of TR are asymptomatic. Symptoms of TR include clinical manifestations related to right heart failure such as peripheral edema and abdominal distention. If left heart failure or pulmonary hypertension is the underlying etiology of TR, the patient might have symptoms related to these diseases.

History

Patients with suspected or diagnosed TR should be asked about symptoms related to right heart failure in order to assess the clinical severity of TR. Pediatric patients should be assessed for growth and development in order to evaluate whether TR is associated with failure to thrive.[1]

Patients should also be asked about symptoms or known history of possible causes of primary TR:

In addition, patients should be asked about symptoms and possible causes of left heart failure and pulmonary hypertension, which are the most common causes of secondary TR. When the patient is asked about left heart failure, it is optimal to obtain details about the following:

When the patient is asked about pulmonary hypertension, it is optimal to obtain details about the following:

Symptoms

Symptoms Related to Heart Failure

Symptoms Related to Pulmonary Hypertension

References

  1. Anyanwu AC, Adams DH (2010). "Functional tricuspid regurgitation in mitral valve disease: epidemiology and prognostic implications". Semin Thorac Cardiovasc Surg. 22 (1): 69–75. doi:10.1053/j.semtcvs.2010.05.006. PMID 20813320.
  2. Croxson MS, O'Brien KP, Lowe JB (1971). "Traumatic tricuspid regurgitation. Long-term survival". Br Heart J. 33 (5): 750–5. PMC 487246. PMID 5115020.
  3. Baseman DG, O'Suilleabhain PE, Reimold SC, Laskar SR, Baseman JG, Dewey RB (2004). "Pergolide use in Parkinson disease is associated with cardiac valve regurgitation". Neurology. 63 (2): 301–4. PMID 15277624 PMID: 15277624 Check |pmid= value (help).
  4. Bruce CJ, Connolly HM (2009). "Right-sided valve disease deserves a little more respect". Circulation. 119 (20): 2726–34. doi:10.1161/CIRCULATIONAHA.108.776021. PMID 19470901.

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