This is a disorder involving backward flow of blood across the tricuspid valve which separates the right ventricle (lower chamber) from the right atrium (upper heart chamber). The most common cause is due to enlargment of the right ventricle, which may be a complication of any disorder that causes failure of the right ventricle. Diseases may cause tricuspid regurgitation and include rheumatic fever. The use of the diet medication call “Phen-fen” is also a risk factor for tricuspid regurgitation, also known as tricuspid insufficiency. Congenital heart disease, carcinoids, rheumatic arthritis, radiation thearpy, Marfan’s syndrome, or injury may cause it.
Symptoms:
TR may not produce any symptoms if the patient does not have pulmonary hypertension. If moderate to severe tricuspid regurgitation exists along with pulmonary hypertension, symptoms may include pulsing in the neck veins, sswelling of the abdomen, feet, and/or ankles. There may be fatigue, weakness, decreased urine output, or general swelling.
Risk Factors:
The most common cause of tricuspid regurgitation is swelling of the right ventricle. Such swelling may be a complication of any disorder that causes failure of the right ventricle. Tricuspid regurgitation may also be caused by or made worse by valve disease on the left side of the heart such as mitral regugitation and mitral stenosis.
Other diseases can directly affect the tricuspid valve. The most common of these is rheumatic fever, which is a complication of untreated strep throat infections.
Tricuspid regurgitation may be found in those with a type of congenital heart disease called Ebstein's anomaly.
Other infrequent causes of tricuspid regurgitation include:
- Carcinoid tumors, which release a hormone that damages the valve
- Marfan syndrome
- Injury
- Rheumatoid arthritis
- Radiation therapy
Another important risk factor for tricuspid regurgitation is use of the diet medications called "Fen-Phen" (phentermine and fenfluramine) or dexfenfluramine.
How it is Diagnosed:
While examining the chest with the hand (palpation), there may be a lift produced by the beating of the enlarged right ventricle. There may be a pulse felt over the liver. The liver and spleen may be enlarged. An electrocardiogram or echocardiogram may show enlargement of the right side of the heart. Doppler echocardiography or cardiac catheterization and be used to measure blood pressures inside the heart and lung.
Treatment Options:
Treatment may not be needed if there are few or no symptoms. Some people may be able to have surgery to repair or replace the tricuspid valve. Notify your health care provider and dentist about any history of heart valve disease before treatment of any condition. Any dental work, including cleaning, and any invasive procedure can introduce bacteria into the bloodstream; antibiotics may be prescribed. Treat strep infections promptly to prevent rheumatic fever.