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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

Nucleus factsheet image
© 2009 Nucleus Medical Media, Inc.

Causes

Rheumatic fever is the most common cause of tricuspid valve disease world-wide. Other causes include:

Risk Factors    TOP

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    TOP

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    TOP

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    TOP

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    TOP

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/index.htm

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca/home/index_e.aspx
Canadian Family Physician
http://www.cfpc.ca/cfp/

References:

Berkow R. The Merck Manual of Medical Information . New York, NY: Pocket; 2000.
Kasper DL, Harrison TR. Harrison's Principles of Internal Medicine . 16th ed. New York, NY: McGraw-Hill; 2005.
Last reviewed September 2009 by David N. Smith, MD
Last Updated: 9/30/09

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