Tricuspid Valve Disease
(Tricuspid Regurgitation; Tricuspid Stenosis)
Definition
Tricuspid valve disease refers to damage to the tricuspid heart valve. This valve is located between the atrium (upper chamber) and the ventricle (lower pumping chamber) of the right side of the heart. The tricuspid valve has three cusps, or flaps, that control the direction and flow of blood.
The two main types of tricuspid valve disease are:
- Tricuspid stenosis—narrowing of the tricuspid valve
- Tricuspid regurgitation—backflow of blood into the atrium from the ventricle due to improper closing of the tricuspid valve flaps
Anatomy of the Heart
Causes
Rheumatic fever is the most common cause of tricuspid valve disease world-wide. Other causes include:
- Congenital heart problems
- Heart attack or coronary heart disease
- Congestive heart failure
- Endocarditis (an infection of heart valves)
- Trauma to the heart
- Tumors (rare)
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
- History of rheumatic fever
- Sex: female (for tricuspid stenosis)
Symptoms
In many cases, there are no symptoms. However, if symptoms do occur, they may include:
- Difficulty breathing
- Fatigue
- Sensation of rapid or irregular heartbeat (palpitations)
- Swelling in the legs or abdomen
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor may be alerted to tricuspid valve disease by the following:
- Heart murmur
- Irregular pulse or heartbeat
- Abnormal pulse in the jugular vein of the neck
- Swelling in the legs
Tests may include:
- Chest x-ray —a test that uses radiation to take pictures of structures inside the chest
- Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
- Echocardiogram —a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
- Cardiac catheterization —an x-ray of the heart's circulation that is done after injection of a contrast dye
Treatment
If you have mild tricuspid valve disease, your condition will need to be monitored, but may not need immediate treatment. When symptoms become more severe, treatments may include:
Medications
Drugs may be prescribed to treat specific symptoms associated with tricuspid valve disease. These medications include:
- Drugs to control heart arrhythmias
- Diuretics
- Vasodilators, which dilate blood vessels
Surgery
If tricuspid valve disease is causing severe problems, surgery to repair or replace the defective valve may be required.
Prevention
Tricuspid valve disease cannot be prevented. But, there are several things you can do to try to avoid some of the complications:
- If you have an abnormal valve, take antibiotics before any dental cleaning, dental work, or other invasive procedures. This will help prevent infection of the heart valve.
- Treat strep throat infections promptly to avoid rheumatic fever, which can cause scarring of the heart valve.
- If your valve problem was caused by rheumatic fever, talk to your doctor about antibiotic treatment to prevent future episodes of rheumatic fever.
RESOURCES:
American Heart Association
http://www.americanheart.org
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov
CANADIAN RESOURCES:
Canadian Cardiovascular Society
http://www.ccs.ca/home/index_e.aspx
Canadian Family Physician
http://www.cfpc.ca/cfp/
References:
Harrison's Principles of Internal Medicine . 15th ed. McGraw-Hill Professional Publishing; 2001.
Merck Manual of Diagnosis and Therapy . 17th ed. Merck & Co; 1999.
Last reviewed November 2008 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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