Scenario 3 - tricuspid regurgitation

Question 1

Which population are particularly at risk of tricuspid regurgitation?

Answer 1

IVDUs

Question 2

Recall 2 symptoms of tricuspid regurgitation

Answer 2

Fever

Malaise

Question 3

Recall 3 signs of tricuspid regurgitation

Answer 3

1. High temp
2. Raised JVP to earlober
3. Pansystolic murmur louder on inspiration

Question 4

Which murmurs are louder on inspiration and why?

Answer 4

Right-sided

Increased venous return to right heart as lungs are mechanically squeezed

Question 5

Where does mitral regurgitation radiate to?

Answer 5

Axilla

Question 6

Recall 3 cardiac differentials for raised JVP - and which of these causes the steepest rise

Answer 6

1. Right heart failure
2. Tricuspid regurgitation - steepest: up to earlobes
3. Constrictive pericarditis

Question 7

What is the most common cause of right heart failure?

Answer 7

Pulmonary hypertension

Question 8

What is most common cause of tricuspid regurgitation?

Answer 8

Infective endocarditis in IVDUs

Question 9

What is the most commonly implicated pathogen in infective endocarditis affecting the tricuspid valve?

Answer 9

Methicillin-sensitive staphylococcus aureus

Question 10

What 3 causes of constrictive pericarditis

Answer 10

TB
Inflammation secondary to connective tissue disease
Malignancy

Question 11

Recall one associated symptom of TB-induced chest pain

Answer 11

Ascites

Question 12

What is the characteristic finding upon auscultation in aortic stenosis?

Answer 12

Soft S2