Tricuspid Regurgitation

1 What is Tricuspid Valve Regurgitation?

Tricuspid valve regurgitation is the condition in which the leaflets of the valves are not able to close properly and leads to backflow of blood in to right atrium from ventricle.

This disorder can be present from birth (congenital) or can be acquired due to other conditions. In case of mild condition, treatment may not be required but monitoring would be necessary. However, surgery would be required in case of severe conditions.

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2 Symptoms

There are no symptoms for mild tricuspid valve regurgitation but severe ones can cause the following signs and symptoms:

Signs of pulmonary hypertension may also appear like fatigue, weakness, difficulty exercising and shortness of breath.

3 Causes

The cause for tricuspid valve regurgitation is unknown. It may be caused by several factors like:

  • Dilated cardiomyopathies.
  • Ebstein anomaly (lower position of the leaflets of the valves than normal).
  • Infective endocarditis ( bacterial infection that affects the inner lining of the heart).
  • Carcinoid syndrome (spreading of cancer from lungs or gastrointestinal tract to the heart).
  • Implantable devices (artificial pacemaker or other devices may cause injury to the valve).
  • Endomyocardial biopsy (while taking a sample of endocardium, damage of the valves may occur).
  • Blunt chest trauma, rheumatic fever (an untreated strep throat may lead this infection).
  • Congenital heart disease (presence of other congenital disease may play an important role in the development).
  • Marfan syndrome (a congenital disorder can also cause tricuspid valve regurgitation).
  • Medications (certain medications which affect the heart may increase the risk of such disease) and radiation (the free radicals formed inside the body may possibly lead to this disease).

4 Making a Diagnosis

Making a diagnosis tricuspid valve regurgitation is done by performing several tests.

The doctor would start with physical examination which is often not enough. The following tests may be recommended:

  • Echocardiogram- Ultrasound of heart.
  • Cardiac MRI- Electromagnetic waves are passed through heart to get detailed picture of the valves.
  • ECG (electrocardiogram)- The electrical activity of the heart is measured.
  • Chest X-ray- The size and the shape of the heart is evaluated.
  • Electrophysiological Tests- This test can reveal any arrhythmias if present.
  • Exercise test or Stress Test- This measures the activity tolerance and is compared with normal. In severe cases, when other methods have failed to confirm diagnosis, cardiac catheterization is used.

5 Treatment

Treatment for tricuspid valve regurgitation depends on the severity of the disease. In case of mild conditions, no treatment is required but in severe cases following treatment may be required:

  • Regular monitoring.
  • Medications that ease the symptoms of the disease.
  • Surgery to repair or replace the tricuspid valve.

The surgical options include:

  • Heart valve repair by separating tethered valve leaflets, by closing valve leaflets and by reshaping the leaflets.Heart valve replacement is preferred when it cannot be repaired. Maze procedure which is required to be done when the heart rate is fast during the replacement.
  • Catheter ablation is used in case of fast or abnormal heart rhythms while replacing the valves. Women with tricuspid valve regurgitation who wants to become pregnant should talk about possible outcomes and be evaluated by a cardiologist before becoming pregnant.

6 Lifestyle and Coping

Your doctor may recommend some lifestyle changes to improve your heart health and to cope with tricuspid valve regurgitation, including:

  • Eating a healthy nutritious diet which has less fats and cholesterol.
  • Exercise regularly but in a limited manner.
  • Preventing infective endocarditis by taking antibiotics as prescribed.
  • Discussing with the doctor about becoming pregnant and going regular evaluation as scheduled.
  • Taking medications as prescribed.
  • Getting support from special support groups and staying active while getting adequate rest.

7 Risks and Complications

There are several risks and complications associated with tricuspid valve regurgitation.

Certain conditions like infective endocarditis, rheumatic fever, heart attack, heart failure, pulmonary hypertension, heart disease, heart disease, congenital heart disease and use of certain medications and radiation disease may increase the risk of having tricuspid valve regurgitation significantly.

An untreated case of tricuspid valve regurgitation may lead to heart failure (due to weakening of the valves) and atrial fibrillation.

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