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Tricuspid Regurgitation Causes Symptoms Diagnosis Management Explained
Tricuspid regurgitation explained in detail with causes, pathophysiology, clinical features, diagnosis, echocardiography findings, and stepwise medical and surgical management for exams and practice.
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Frequently Asked Questions
❓ What is tricuspid regurgitation?
Tricuspid regurgitation is a condition in which the tricuspid valve fails to close properly, allowing backward flow of blood from the right ventricle into the right atrium during systole.
❓ What is the most common cause of tricuspid regurgitation?
The most common cause is functional tricuspid regurgitation due to right ventricular dilation, usually secondary to pulmonary hypertension or left-sided heart disease.
❓ Why does the tricuspid regurgitation murmur increase during inspiration?
Inspiration increases venous return to the right side of the heart, augmenting right ventricular stroke volume and intensifying right-sided murmurs, known as Carvallo sign.
❓ What are the characteristic jugular venous pressure findings in tricuspid regurgitation?
Jugular venous pressure shows elevated JVP with prominent systolic v waves due to regurgitant flow into the right atrium during ventricular systole.
❓ How is tricuspid regurgitation diagnosed?
Tricuspid regurgitation is primarily diagnosed using transthoracic echocardiography with color Doppler, which assesses severity, mechanism, right ventricular function, and pulmonary pressures.
❓ What echocardiographic feature indicates severe tricuspid regurgitation?
A dense, early-peaking triangular continuous-wave Doppler jet along with systolic flow reversal in hepatic veins indicates severe tricuspid regurgitation.
❓ What are common symptoms of severe tricuspid regurgitation?
Symptoms include fatigue, peripheral edema, ascites, abdominal fullness, hepatomegaly, and features of right-sided heart failure.
❓ How is functional tricuspid regurgitation managed medically?
Medical management includes diuretics for volume overload and treatment of the underlying cause such as pulmonary hypertension, atrial fibrillation, or left-sided heart disease.
❓ When is surgery indicated in tricuspid regurgitation?
Surgery is indicated in symptomatic severe tricuspid regurgitation, progressive right ventricular dysfunction, or moderate tricuspid regurgitation with annular dilation during left-sided valve surgery.
❓ Which surgical approach is preferred for tricuspid regurgitation?
Tricuspid valve repair with annuloplasty is preferred over valve replacement as it preserves right ventricular function and has fewer long-term complications.