Tricuspid Stenosis

Question 1

Symptoms

Answer 1

Right heart failure

Symptoms of carcinoid syndrome (flushing, diarrhoea etc)

Question 2

Signs

Answer 2

• raised JVP
• peripheral oedema
• a mid-diastolic murmur is very rarely audible
• if TS is suspected then check for hepatomegaly (due to congestion or carcinoid)

Question 3

Investigations

Answer 3

Echo appearances of TV distinctive in carcinoid syndrome - leaflets thickened, retracted and immobile giving rise to both TS and severe TR

Question 4

Aetiology

Answer 4

1. Carcinoid syndrome
2. Rheumatic fever (although right-sided involvement rare)
3. Congenital - partial tricuspid atresia

Question 5

Management

Answer 5

If the right-sides symptoms are uncontrollable then valve replacement can be performed