Condition- Tricuspid Regurgitation Flashcards
What is tricuspid regurgitation?
Backflow of blood from the RV to the RA across the tricuspid valve during systole
List some causes of tricuspid regurgitation- which is the most common
- CONGENITAL:
- Ebstein’s anomaly (malpositioned tricuspid valve)
- Cleft valve in ostium primum)
- FUNCTIONAL
- RV dilation due to pulmonary hypertension
- Valve prolapse
- Rheumatic heart disease
- Infective endocarditis (in IVD)
- Other: carcinoid syndrome, cirrhosis
List some of the presenting symptoms of tricuspid regurgitation
Learn Symptoms By Just Nailing Acronyms: Tricuspid Errors Produce Heart Palpitations
- Leg Swelling/ Ascites/ Oedema (fluid retention symptoms)
- Breathlessness
- Jaundice
- Nausea
- Anorexia
- Tiredness
- Epigastric Pain (made worse by exercise)
- Headache
- Palpitations
What might you hear on auscultation of a patient with tricuspid regurgitation?
- Pansystolic murmur heard at lower left sternal border
- Louder on inspiration
- Louder P2 component of second heart sound
What other signs might you see on physical examination of a patient with tricuspid regurgitation
- irregularly irregular pulse
- I: Raised JVP (which may oscillate the earlobes)
- P: Parasternal heaves
- A: Pansystolic murmur louder on inspiration
- Chest: pleural effusion
- Abdo: palpable liver, ascites, jaundice
- Legs: pitting oedema
Which investigation is required to accurately diagnose and assess the cause and severity of tricuspid regurg
Echocardiogram
May show valve prolapse + right v dilation
What might you see on an ECG of a patient with TR?
P pulmonale due to right atrial hypertrophy
List some investigations you could conduct on a patient with TR?
- BEDSIDE: ECG= p-mitrale
- BLOODS: FBC, LFT, cardiac enzymes, blood cultures
- IMAGING:
- CXR= right sided enlargement of cardiac shadow
- Echo
- Right hear catheterisation= pulmonary artery pressure
