Tricuspid regurgitation Health Article

Definition

Tricuspid regurgitation is a disorder in which the heart's tricuspid valve does not close properly, causing blood to flow backward (leak) into the right upper heart chamber (atrium) when the right lower heart chamber (ventricle) contracts.

Alternative Names

Tricuspid insufficiency

Causes, incidence, and risk factors

The tricuspid valve separates the right lower heart chamber (the right ventricle) from the right upper heart chamber (right atrium).

The most common cause of tricuspid regurgitation is swelling of the right ventricle. Such swelling may be a complication of any disorder that causes failure of the right ventricle.

Other diseases can directly affect the tricuspid valve. The most common of these is rheumatic fever, which is a complication of untreated strep throat infections.

Tricuspid regurgitation affects about 4 out of 100,000 people. It may be found in those with a type of congenital heart disease called Ebstein's anomaly.

Other infrequent causes of tricuspid regurgitation include:

• Carcinoid tumors, which release a hormone which damages the valve
• Marfan syndrome
• Injury
• Rheumatoid arthritis
• Radiation therapy

Another important risk factor for tricuspid regurgitation is use of the diet medications called "Fen-Phen" (phentermine and fenfluramine) or dexfenfluramine.

Symptoms

Tricuspid regurgitation may not cause any symptoms if the patient does not have pulmonary hypertension. If pulmonary hypertension and moderate-to-severe tricuspid regurgitation exist together, the following symptoms may result:

• Active pulsing in the neck veins
• Decreased urine output
• Fatigue, tiredness
• General swelling
• Swelling of the abdomen
• Swelling of the feet and ankles
• Weakness

Signs and tests

The health care provider may detect abnormalities when when gently pressing with the hand (palpating) on your chest. The doctor may also feel a pulse over your liver. The physical exam may reveal liver and spleen swelling.

Listening to the heart with a stethoscope shows a murmur or abnormal sounds.There may be signs of fluid collection in the abdomen.

An ECG or echocardiogram may show swelling of the right side of the heart. Doppler echocardiography or right-sided cardiac catheterization are used to measure blood pressures inside the heart and lung.