The tricuspid valve is between the right atrium (a top chamber) and right ventricle (a bottom chamber) in the heart. Stenosis is a narrowing of the valve opening. The valve opens when the atrium contracts to let blood into the ventricle. It closes when the ventricle contracts to stop blood flow back to the atrium. A narrow opening means that blood doesn’t flow easily. The atrium works harder, so it gets bigger, and becomes less effective in moving blood to the right ventricle.
Tricuspid stenosis is almost always related to rheumatic heart disease (from infection with streptococcal bacteria). It’s usually found with mitral and aortic valve problems. Tricuspid valve damage may rarely be congenital (present at birth).
People with mild tricuspid stenosis may have no symptoms. Symptoms 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, chest pain, and fatigue.
The health care provider makes a preliminary diagnosis from the medical history and physical examination. Blood moving abnormally through valves makes an abnormal sound called a murmur. Its timing in the heart’s cycle and location help tell which valve is affected. Additional tests to diagnose tricuspid stenosis may include an 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 heart rhythms (arrhythmias).
Treatment varies depending on severity, age, and overall health. Treatment of mild conditions tries to prevent complications. Salt and fluid restriction is important to prevent swelling (edema) of the arms and legs. Some people with irregular heart beat known as atrial fibrillation take anticoagulant medicine to prevent blood clots. For heart failure, diuretics lower blood fluid volume so the heart doesn’t work as hard. Vasodilator medicines may be used when heart failure gets worse. Treatment options in some people may include having the valve stretched with a catheter (tube). The catheter has an attached balloon that is inflated in the valve and stretches it (balloon valvuloplasty). Severe tricuspid stenosis may require valve replacement.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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