Tricuspid Regurgitation Flashcards
What is tricuspid regurgitation?
backflow of blood from RV to RA during systole
What are 4 aetiological causes of tricuspid regurgitation?
Infective Endocarditis
Congenital: Ebstein’s anomaly
Functional: RV dilatation (e.g. pulmonary HTN), damage to valve leaflets
Rheumatic Heart Disease
What is the most common cause of TR?
Infective endocarditis
List 4 symptoms in TR
Fatigue
Hepatic pain OE
Anorexia
Dyspnoea
Describe the pulse in TR
Irregularly irregular if AF
List the necessary bloods to be taken in TR
FBC
LFT
Cardiac enzymes
Blood cultures
Describe the JVP in TR. What causes this?
Very Raised JVP
Giant V waves
Caused by transmission of high RV pressures into the great veins
Giant A waves may also be present
What is heard on auscultation in TR?
Pansystolic murmur: heard best at lower left sternal edge
Louder on inspiration (Carvallo sign)
What is felt on palpation in TR?
Parasternal heave
What is found on abdominal examination in TR?
Pulsatile Hepatomegaly
Ascites
Peripheral oedema
Jaundice
What may be seen on an ECG in TR?
P pulmonale: due to right atrial hypertrophy
What may be seen on CXR in TR?
Right-sided enlargement of cardiac shadow
What may be seen on echocardiogram in TR?
Extent of regurgitation can be estimated using Doppler ultrasound
May show valve prolapse + RV dilation
Although rarely used, why may Right Heart Catheterisation be useful in TR?
For assessing pulmonary artery pressure
What must be remembered about right sided murmurs?
rIght sided murmurs are loudest on Inspiration
