The tricuspid valve is between the right atrium (a top chamber) and right ventricle (a bottom chamber) in the heart. The valve opens when the atrium contracts to let blood into the ventricle. It closes when the ventricle contracts to stop blood flow back (regurgitation) into the atrium. In regurgitation, some blood flows back, so the atrium works harder and gets bigger (enlarged).
Tricuspid valve abnormalities are uncommon and often occur with abnormalities of other valves. Tricuspid valve damage may be congenital (present at birth). The most common cause is enlargement of the right ventricle secondary to pulmonary hypertension (increased pressure in the lung blood vessels). Heart infections such as rheumatic fever (from streptococcal infection) or bacterial endocarditis can cause it. Most teens and young adults with tricuspid regurgitation have congenital abnormalities.
People with mild tricuspid regurgitation may have no symptoms. Symptoms that do occur usually start after several years. They include swelling in the feet, legs, or abdomen (belly) and breathing problems, especially when lying down. Other symptoms are uneven heartbeat, coughing up blood, and chest pain. Weakness, tiredness, and low urine volume may occur. People may develop an irregular heartbeat called atrial fibrillation. When this occurs, the atrium doesn’t contract normally, blood pools in the atrium, and clots may form. These clots may travel to the brain and cause strokes.
The health care provider makes a preliminary diagnosis from the medical history and physical examination. Blood moving abnormally through valves makes a sound called a murmur. Its timing in the heart’s cycle and location help tell which valve is affected. Tests to help diagnose tricuspid regurgitation may include echocardiography, chest X-rays, and electrocardiography (ECG). Echocardiography is an ultrasound examination of the heart. ECG shows changes in the electrical system of the heart such as abnormal rhythms (arrhythmias).
Treatment depends on severity, age, and overall health. For mild conditions, no treatment is needed. Some people with atrial fibrillation take anticoagulant medicine to prevent blood clots. For heart failure, diuretics lower blood fluid volume so the heart doesn’t have to work as hard. Vasodilator medicines may be used when heart failure becomes worse. Severe tricuspid regurgitation may require valve replacement or repair (valvuloplasty).
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