Tricuspid Regurgitation Flashcards
Define Tricuspid Regurgitation?
Backflow of blood from the right ventricle to the right atrium during systole
What is the aetiology of Tricuspid Regurgitation?
Congenital Functional Rheumatic Heart Disease Infective Endocarditis Other causes
What are some of the congenital causes of Tricuspid Regurgitation?
Ebstein’s Anomaly (malpositioned tricuspid valve)
Cleft valve in ostium primum
What are some fo the functional causes of Tricuspid Regurgitation?
Consequence of right ventricular dilation (e.g. due to pulmonary hypertension)
Valve prolapse
What are some of the other causes of Tricuspid Regurgitation?
Carcinoid Syndrome
Trauma
Cirrhosis
Iatrogenic
What is the epidemiology of Tricuspid Regurgitation?
Differs based on cause
Infective Endocarditis is the most common cause
What is the presenting symptoms of Tricuspid Regurgitation?
Fatigue Breathlessness Palpitations Headaches Nausea Anorexia Epigastric pain made worse by exercise Jaundice Lower Limb Swelling
What is the pulse like on Tricuspid Regurgitation?
Irregularly irregular if AF
What is the signs of Tricuspid Regurgitation on inspection?
Raised JVP with giant V waves (which may oscillate the earlobes)
This is caused by transmission of high right ventricular pressures into the great veins
Giant A waves may also be present
What are the signs of Tricuspid Regurgitation on palpation?
Parasternal Heave
What are the signs of Tricuspid Regurgitation on auscultation?
Pansystolic murmur - heard best at lower left sternal edge
Louder on inspiration (Carvallo Sign)
Loud P2 component of second heart sound
What might you see on Chest Examination for Tricuspid Regurgitation?
Signs of:
- Pleural Effusion
- Causes of pulmonary hypertension
What might you see on Abdominal Examination for Tricuspid Regurgitation?
Palpable liver (tender, smooth and pulsatile) Ascites
What might you see on the legs for Tricuspid Regurgitation?
Pitting Oedema
What bloods would you do for Tricuspid Regurgitation?
FBC
LFT
Cardiac Enzymes
Blood Cultures
