Tricuspid Valvular Disease is a disease of the heart, namely the tricuspid valve between the right ventricle and right atrium.
These valvular lesions are rare, particularly in isolation.
Tricuspid stenosis (TS) is usually due to rheumatic fever and is usually seen in association with left heart valve disease. TS is also sometimes associated with carcinoid syndrome. Tricuspid regurgitation (TR) is usually secondary to right ventricular dilatation as in pulmonary vascular disease. Primary TR is less common and usually caused by rheumatic heart disease or infective endocarditis (heart valve infection).
TS: Causes a reduction in cardiac output that is compensated for by right atrial hypertrophy. Eventually, the back pressure causes a syndrome of right heart failure. TR: causes a volume over load of the right heart with dilatation of the right atrium. Right heart failure ensues. Atrial arrhythmias, particularly atrial fibrillation are common due to the dilatation of the right atrium.
Chest x-ray may show an atrial bulge in either condition. An ECG may show evidence of right atrial hypertrophy with tall peaked p-waves.
The prognosis of tricuspid valve disorders is good. Right heart failure should be treated with standard measures. Surgical replacement of the valves may be necessary to improve symptoms and prevent irreversible cardiac changes that arise which long term cardiac dysfunction.
Medical treatment of complications such as right heart failure (diuretics, salt restrictions). Surgical options such as valve replacements are sometimes necessary for more severe disease.
Hurst's The Heart 8th Edition, McGRAW-HILL 1994. Kumar and Clark Clinical Medicine 4th Edition, W.B SAUNDERS 1998.
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