Tricuspid regurgitation is an acquired heart defect that causes blood to remain in the right atrium and venous system. Not only do the symptoms typical of all valve defects appear, but also other symptoms that are attributed only to tricuspid valve insufficiency. Find out what are the causes and symptoms of tricuspid regurgitation. What tests should be performed to make a diagnosis? What is the treatment of this heart defect? ​​

Tricuspid regurgitationisa heart defectcausing abnormal regurgitation of blood from the right ventricle to the right atrium.

The tricuspid valveis one of the four heart valves. Its function is to prevent the flow of blood from the right ventricle to the right atrium and thus keep the heart working efficiently. A properly functioning tricuspid valve closes during contraction of the ventricles, cutting off the connection between the right atrium and the right ventricle. In this way, blood is pumped through the right ventricle only in the correct direction - to the pulmonary trunk. When the valve does not close properly, blood from the right ventricle flows back into the right atrium. This leads to an overload and enlargement of the right atrium.

Contents:

  1. Tricuspid regurgitation - causes
  2. Tricuspid regurgitation - symptoms
  3. Tricuspid regurgitation - diagnosis
  4. Tricuspid regurgitation - treatment

Tricuspid regurgitation - causes

Functional causes:

  • cardiovascular diseases: pulmonary hypertension, mitral valve stenosis, congenital pulmonary artery stenosis, dilated cardiomyopathy, papillary muscle dysfunction, e.g. after a heart attack

Organic causes:

  • inflammatory diseases: infective endocarditis, rheumatic fever, rheumatoid arthritis, systemic lupus
  • degenerative diseases - Marfan's syndrome, Whipple's disease, carcinoid syndrome
  • birth defects - Ebstein anomaly
  • taking anorexic drugs, methysergide (also in migraine) or fenfluramine, taking pergolide (Parkinson's disease)

Regurgitationtricuspid - symptoms

As a result of volume overload and right atrial enlargement, pressure gradually increases in the right atrium, which is transferred to the main veins that enter it, and then to the entire venous system. The consequence of this process is venous blood stasis, which in patients with a milder form of the defect may cause reduced exercise tolerance, palpitations and exercise dyspnea. It should be remembered that tricuspid regurgitation is often accompanied by another pathology of the heart - mitral stenosis, therefore these symptoms may be due to the presence of this defect rather than the tricuspid regurgitation itself.

In patients with advanced disease, the following appear:

Symptoms:

  • decreased exercise tolerance
  • weakness
  • pain in the right hypochondrium, a feeling of crushing and stretching in the right hypochondrium

Physical symptoms:

  • clear pulsation of the jugular veins, pulsation of the eyeballs and the vessels on the head and neck
  • liver pulsation, increasing during inhalation (as a result of its hyperemia)
  • glaucous-yellow color of the skin
  • swelling of the subcutaneous tissue
  • increase in abdominal circumference (due to the accumulation of fluid in the peritoneal cavity, i.e. ascites)
  • digestive system insufficiency as a result of its hyperemia
  • clear negative venous pulse

Tricuspid regurgitation - diagnosis

During the stethoscope examination, you can hear a systolic murmur at the site of the attachment of the 5th right rib to the sternum, which is louder during deep inhalation, and a rattling diastolic murmur (when exhaling). It is the basis for the following tests:

  • EKG - on its basis, it is possible to recognize right atrial enlargement and features of right ventricular hypertrophy, as well as atrial fibrillation
  • Chest X-ray - enlargement of the heart figure, features of right atrium dilatation, and in severe regurgitation, adherence of the right ventricle to the sternum and pleural fluid

The decisive factor in the diagnosis and assessment of the advancement of the defect is the heart echo, i.e. the echocardiographic examination of the heart, thanks to which the degree of the defect can be determined:

  • regurgitation wave
  • increased systolic pressure in the right ventricle (indicates functional regurgitation)
  • widening of the inferior vena cava
  • widening of the liver veins
  • low pulmonary artery pressure (indicates an organic cause of the defect)

Tricuspid regurgitation - treatment

Treatment, as in the case of other valvular heart disease, depends on the severity of the defect, its cause, and the severity of clinical symptoms.

People with asymptomatic regurgitation and normal pressure in the pulmonary artery ( <60 mmHg) zwykle nie wymagają leczenia. Powinni jedynie unikać nadmiaru płynów (do 1,5-2 l/dobę), soli (2-3 g/dobę) i codziennie kontrolować masę ciała Przyrost masy ciała więcej niż 2 kg w ciągu 3 dni może świadczyć o zatrzymywaniu wody w organizmie, co może przyczynić się do niewydolności krążenia. Konieczne są regularne wizyty u kardiologa.

If the regurgitation is accompanied by stenosis of the mitral valve, correction of the latter defect can restore the proper functioning of the tricuspid valve.

Indications for surgical treatment:

  • isolated defect, i.e. severe tricuspid regurgitation itself
  • advanced tricuspid regurgitation with associated mitral stenosis

The surgical procedure consists in replacing the valve with a biological (preferred) or artificial valve. Patients after this type of surgery must take oral anticoagulants (acenocoumarol) for the rest of their lives.

Category:

Cardiology