• 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
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    Causes

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

    Risk Factors

    Factors that increase your chance of getting tricuspid valve disease include:
    • 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
    • Swelling in the legs or abdomen

    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. 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
    Images may need to be taken to examine your heart. This can be done with:
    Your heart's activity may need to be measured. This can be done with electrocardiogram (ECG, EKG).

    Treatment

    If you have mild tricuspid valve disease, your condition will need to be monitored, but may not need treatment right away. 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 may be prescribed to treat specific symptoms associated with tricuspid valve disease. These medications include:
    • Drugs to control heart arrhythmias
    • Diuretics to promote the production of urine
    • Vasodilators, which dilate blood vessels

    Surgery

    If tricuspid valve disease is causing severe problems, surgery to repair or replace the valve may be required.
    If tricuspid valve disease is causing severe problems, surgery to repair or replace the 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:
    • Treat strep throat infections right away 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.
    • Most people with a tricuspid valve defect do not need to take antibiotics to prevent infections before dental or medical procedures. But, there are exceptions. Check with your doctor to see if your condition requires you take antibiotics.

    RESOURCES

    American Heart Association http://www.heart.org

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca

    The College of Family Physicians of Canada http://www.cfpc.ca

    References

    Antibiotic prophylaxis. American Dental Association website. Available at: http://www.ada.org/2157.aspx . Accessed March 14, 2013.

    Berkow R. The Merck Manual of Medical Information . New York, NY: Pocket; 2000.

    Diseases of the tricuspid valve. Texas Heart Institute website. Available at: http://www.texasheartinstitute.org/HIC/Topics/Cond/vtricus.cfm. Updated August 2012. Accessed March 14, 2013.

    Kasper DL, Harrison TR. Harrison's Principles of Internal Medicine . 16th ed. New York, NY: McGraw-Hill; 2005.

    Tricuspid valve disease. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/heart/disorders/valve/tricuspid.aspx. Updated November 2012. Accessed March 14, 2013.

    Revision Information

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