Tricuspid insufficiency; Heart valve - tricuspid regurgitation; Valvular disease - tricuspid regurgitation
Blood that flows between different chambers of your heart must pass through a heart valve. These valves open up enough so that blood can flow through. They then close, keeping blood from flowing backward.
The tricuspid valve separates the right lower heart chamber (the right ventricle) from the right upper heart chamber (right atrium).
Tricuspid regurgitation is a disorder in which this valve does not close tight enough. This problem causes blood to flow backward into the right upper heart chamber (atrium) when the right lower heart chamber (ventricle) contracts.
An increase in size of the right ventricle is the most common cause of this condition. The right ventricle pumps blood to the lungs where it picks up oxygen. Any condition that puts extra strain on this chamber can cause it to enlarge. Examples include:
Tricuspid regurgitation may also be caused or worsened by infections, such as:
Less common causes of tricuspid regurgitation include:
Mild tricuspid regurgitation may not cause any symptoms. Symptoms of heart failure may occur, and can include:
The health care provider may find abnormalities when gently pressing with the hand (palpating) on your chest. The provider may also feel a pulse over your liver. The physical exam may show liver and spleen swelling.
Listening to the heart with a stethoscope may reveal a murmur or other abnormal sounds. There may be signs of fluid buildup in the abdomen.
An ECG or echocardiogram may show enlargement of the right side of the heart. Doppler echocardiography or right-sided cardiac catheterization may be used to measure blood pressure inside the heart and lungs.
Other tests, such as CT scan or MRI of the chest (heart), may reveal enlargement of the right side of the heart and other changes.
Treatment may not be needed if there are few or no symptoms. You may need to go to the hospital to diagnose and treat severe symptoms.
Swelling and other symptoms of heart failure may be managed with medicines that help remove fluids from the body (diuretics).
Some people may be able to have surgery to repair or replace the tricuspid valve. Surgery is most often done as part of another procedure.
Treatment of certain conditions may correct this disorder. These include:
Surgical valve repair or replacement most often provides a cure in people who need an intervention.
The outlook is poor for people who have symptomatic, severe tricuspid regurgitation that cannot be corrected.
Call your provider if you have symptoms of tricuspid regurgitation.
People with abnormal or damaged heart valves are at risk for an infection called endocarditis. Anything that causes bacteria to get into your bloodstream may lead to this infection. Steps to avoid this problem include:
Prompt treatment of disorders that can cause valve or other heart diseases reduces your risk of tricuspid regurgitation.
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Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;135(25):e1159-e1195. PMID: 28298458 pubmed.ncbi.nlm.nih.gov/28298458/.
Pelikka PA. Tricuspid, pulmonic, and multivalvular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 70.
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Review Date: 1/27/2020
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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