Tricuspid Regurgitation Flashcards
What is the difference between Functional and Organic etiologies of TR?
functional: valve is normal but there’s secondary causation of TR
organic: primary caused of abnormal TV
What are the FUNCTIONAL CAUSES of TR?
- annular dilatation due to RVE/RAE
- pulmonary HTN
- RV ichemia/infarct leads to PM dysfunction & tenting
- AICD or Pacer Leads
What measurement is considered SEVERE for Annuluar Dilatation?
> 40 mm
What causes PULMONARY HTN?
- primary: idiopathic ( cause unknown, genetic)
- secondary: heart/lung disease
What are the COMPLICATIONS WITH AICD leads?
- worsening TR in 25%
- thrombus formation
- vegetations
- perforation
- subclavian obstruction
Leadless pacers are available for?
bradyarrhythmia that can be paced from one chamber
Where are the leads placed through and placed?
through subclavian vein into RA, RV and LV
What are the ORGANIC CAUSES of TR?
- rheumatic
- carcinoid
- endocarditis
- ebstein anomaly
- myxomatous TV Prolapse
What is EBSTEIN ANOMALY?
congenital condition where on or more tricuspid leaflets displaced toward ventricular apex
What do you visualize with Ebstein Anomaly?
- septal leaflets most often involved
- RAE
What are the SIGNS and SYMPTOMS of TR?
- signs of overload to right heart and cava
- jugular venous distension
- hepatomegaly
- peripheral edema
What types of AUSCULTATION are heard in TR?
- holosystolic high pitch blowing murmur at xyphoid LSB
- right sided S3
What is RIGHT SIDED S3?
when TV is opened trying to move overloaded RA volume into RV - heard at mid diastole
What are the TREATMENTS of TR?
none required bc usually tolerated but if significant TR - repair/replacement as MV
What are the 2D FINDINGS of TR?
- RVE
- RAE
- dilated IVC/HV
- paradoxic septal motion due to RV volume overload
- flattening of IVS and D shaped LV in PSSAX due to RV volume overload
- abnormality of leaflet or chord
