TRICUSPID

REGURGITATION

OVERVIEW

Tricuspid

regurgitation is a disorder in which the

heart's tricuspid valve does not close properly,
causing blood to flow backward (leak) into the
right upper heart chamber (atrium) when the
right lower heart chamber (ventricle) contracts.

As

the right ventricle contracts to pump blood

forward to the lungs, some blood leaks backward
into the right atrium, increasing the volume of
blood in the atrium. As a result, the right atrium
can enlarge, which can change the pressure in
the nearby chambers and blood vessels.

Causes
RISK FACTORS
The tricuspid valve separates the right lower heart
chamber (the right ventricle) from the right upper
heart chamber (right atrium).
The most common cause of tricuspid regurgitation
isenlargement of the right ventricle, which pumps
blood to the lungs, where it picks up oxygen. This
enlargement may be a complication of any disorder
that causes extra strain on the right ventricle.
Tricuspid regurgitation may also be caused or made
worse by problems with the valves on the left side of
the heart (mitral or aortic valve) or the left ventricle
(which pumps blood from the heart to the rest of the
body). It may also be due to any cause of
pulmonary hypertension(high pressure in the lung
circulation).

Other diseases can directly affect the tricuspid valve. The

most common of these is infective endocarditis, which is
usually due to unsanitary conditions during drug abuse.
Anything that causes bacteria to enter the bloodstream can
also cause endocarditis.
Tricuspid regurgitation may be found inpeople with a type of
congenital heart disease calledEbstein's anomaly.
Other,less commoncauses of tricuspid regurgitation include:
Carcinoid tumors, which release a hormone that damages the
valve
Marfan syndrome
Injury
Rheumatoid arthritis
Radiation therapy
Rheumatic fever
Medications such as "Phen-fen" (phentermine and
fenfluramine)

SIGN AND SYMPTOMS

Tricuspid regurgitation may not cause any
symptoms if the regurgitation is not severe.
However, patients may have:
Active pulsing in the neck veins
Decreasedurine output
Fatigue, tiredness
General swelling
Swelling of the abdomen
Swelling of the feetand ankles
Weakness

EXAMS AND TESTS

The health care provider mayfind abnormalities when
gently pressing with the hand (palpating) on your
chest. The doctor may also feel a pulse over your
liver. The physical exam mayshow liver and spleen
swelling.
Listening to the heart with a stethoscopemay
reveala murmur or other abnormal sounds. There
may be signs of fluid collection in the abdomen.
AnECGorechocardiogrammay showenlargement of
the right side of the heart. Doppler echocardiography
or right-sidedcardiac catheterizationmay beused to
measure blood pressure inside the heart and lungs.
Other tests, such as CT scan or MRI of the chest
(heart), may reveal enlargement of the right side of
the heart and other changes.

TREATMENT
Treatment may not be needed if there are few or no symptoms.
You may need to go to the hospital to diagnose and treat severe
symptoms.
Swelling may be managed with medications (diuretics) that help
remove fluids from the body.
Conditions that cause this problem should be identified and
treated. Some people may be able to have surgery to repair or
replace the tricuspid valve. Surgery is usually done as part of
another procedure.
People with abnormal or damaged heart valves are at risk for an
infection called endocarditis. Anything that causes bacteria to get
into your bloodstream may lead to this infection. Steps to avoid
this problem include:
Avoid unclean injections
Treat strep infections promptly to prevent rheumatic fever
Always tell your health care provider and dentist if you have a
history of heart valve disease or congenital heart disease before
treatment. Guidelines recommend the use of antibiotics for some
patients, but only under certain conditions.

Medical Management
Your

doctor will want to monitor the progress of

your valve disease with regular appointments.
They may be spaced once a year or more often,
if your doctor feels you need to be followed
more closely.
Your appointment will include a medical exam.
Diagnostic studies may be repeated at regular
intervals.
Your physician may prescribe medications to
treat your symptoms.
These medications may include drugs to treat
heart failure or medications to control irregular
heart rhythms.

 Surgical

Management
Tricuspid Valve Repair
When valve disease is severe, it may be
necessary to repair or replace the diseased
valve. Tricuspid valve repair using an
annuloplasty ring is the preferred surgical
approach for tricuspid regurgitation and may
be performed for primary tricuspid disease or
for combined cases with other valve surgery
(mitral, aortic). When the valve cannot be
repaired, a valve replacement will be
performed.

Endocarditis
prevention

If you have tricuspid valve disease, you are at risk for getting
endocarditis, an infection that causes damage to the heart valves
(even if your valve has been repaired or replaced with surgery). You
will need to follow these guidelines:
Tell your doctors and dentist you have valve disease. You may want
to carry a card with this information.
Call your doctor if you have symptoms of an infection (sore throat,
general body achiness, and fever). Colds and flus do not cause
endocarditis. But, infections, which may have the same symptoms,
do. So, to be safe, call your doctor.
Take good care of your teeth and gums to prevent infections. See
your dentist for regular visits.
Take antibiotics before you undergo any procedure that may cause
bleeding:
any dental work (even a basic teeth cleaning)
invasive tests
most major or minor surgery

Outlook (Prognosis)

Treating any conditions, especially high blood

pressure in the lungs and swelling of the right
lower heart chamber, may correct this disorder.
Surgical valve repair or replacement usually
provides a cure. However, persons with severe
tricuspid regurgitation that cannot be corrected
may have a poor prognosis, either from this
condition or the one that caused it.
Possible Complications
Cirrhosis
Endocarditis
Weight loss
Worsening ofheart failure

PREVENTION
Prompt

treatment of disorders
that can cause valve disease
reduces your risk of tricuspid
regurgitation.

TRICUSPID REGURGITATION QUIZ

_____________________is a disorder in which the heart's tricuspid valve does not close properly
As the right ventricle contracts to pump blood forward to the __________, some blood leaks backward into the 3._______________, increasing the volume of
blood in the atrium. As a result, the right atrium can 4.____________, which can change the 5.______________ in the nearby chambers and blood vessels.

SIGN AND SYMPTOMS

_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________

7 RISK FACTORS
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
Tricuspid valve repair using an ___________________ is the preferred surgical approach for tricuspid regurgitation and may be performed for primary tricuspid
disease or for combined cases with other valve surgery (mitral, aortic).

APiiiiR!!!
SALAMAT ..

lovejoyceramos

1Tricuspid regurgitation
2. Lungs
3. right atrium
4. enlarge
5. pressure
6-12
Active pulsing in the neck veins
Decreasedurine output
Fatigue, tiredness
General swelling
Swelling of the abdomen
Swelling of the feetand ankles
Weakness

13-19
Carcinoid tumors
Marfan syndrome
Injury
Rheumatoid arthritis
Radiation therapy
Rheumatic fever
Medications
20. Annuloplasty ring