Tricuspid regurgitation develops when the tricuspid valve between the right atrium and right ventricle does not close properly.
The tricuspid valve controls the blood flow from the right atrium to the right ventricle. The valve opens and closes to control the flow of blood.
Tricuspid regurgitation occurs when the valve does not close properly, which causes some of the blood to leak back into the right atrium. This causes the heart to work harder to move blood through the valve, which may lead to complications.
The article below covers the causes, symptoms, and treatments for tricuspid regurgitation.
Tricuspid regurgitation is fairly common. In the United States, it affects about
The heart pumps blood through the four chambers of the heart in a specific direction. When the heart pumps, valves open and close, which allows blood to travel from one chamber of the heart to another.
The tricuspid valve allows the blood to move from the right atrium to the right ventricle. After the right atrium fills with blood, the tricuspid valve opens and lets blood into the right ventricle. The valve then closes so blood does not flow back into the atrium.
In tricuspid regurgitation, some blood leaks and flows backward into the right atrium. This increases the blood volume in the atrium.
Various conditions can cause tricuspid regurgitation. In some cases, it is due to a congenital heart problem a person is born with. In other instances, a medical condition causes tricuspid regurgitation. The exact mechanism that leads to tricuspid regurgitation may differ in each case.
- heart failure
- pulmonary hypertension (high blood pressure affecting the arteries in the lungs)
- cardiomyopathies (diseases of the heart muscle that weaken the heart)
Less often, tricuspid regurgitation develops due to other factors, such as:
- trauma to the chest
- rheumatic heart disease
- congenital heart defects
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Possible symptoms of tricuspid regurgitation include:
- swelling in the legs, ankles, and feet
- abdominal swelling
- enlarged liver
- pulsing neck veins
- decreased exercise tolerance
Doctors usually diagnose tricuspid regurgitation based on risk factors, symptoms, a physical exam, and diagnostic tests.
The first step in diagnosis involves the doctor asking about a person’s medical history to determine if certain medical conditions put them at risk for tricuspid regurgitation.
Doctors also review symptoms and perform a physical exam. During the exam, the physician listens to the heart through a stethoscope to check for a heart murmur and irregular rhythms.
Diagnostic tests they may recommend include:
- An echocardiogram is the most common test used to diagnose problems with heart valves, such as the tricuspid valve. An echocardiogram uses sound waves to create images of the heart. It allows the doctor to see how efficiently the blood flows through the chambers of the heart.
- An electrocardiogram is another test doctors may use to evaluate arrhythmias that may be associated with tricuspid regurgitation. The test is quick and painless. It involves placing electrodes on the chest that measure the electrical activity of the heart. An electrocardiogram can detect abnormal heart rhythms.
- A stress test involves a person exercising while monitored to determine how well the heart works as the person exercises. In some cases, a stress test also includes performing an echocardiogram immediately following exercise.
Doctors may order additional tests, such as a chest x-ray and blood tests, to rule out other underlying conditions.
Treatment for tricuspid regurgitation
Managing underlying causes of tricuspid regurgitation is also an important part of a treatment plan. An individual can discuss all treatment options with their healthcare professional.
Doctors often prescribe medication to treat tricuspid regurgitation. The exact type of medication may depend on the possible cause of tricuspid regurgitation or complications present.
Medications may include:
- Diuretics: In people with tricuspid regurgitation due to right-sided heart failure, doctors may prescribe diuretics to reduce fluid.
- Antiarrhythmics: This medication helps control abnormal heart rhythms, such as atrial fibrillation, that can develop.
- Anticoagulants: This medication helps decrease the risk of a blood clot and possible stroke.
In some instances, medications may not work effectively enough to treat tricuspid regurgitation. In cases where symptoms are severe in spite of medication, a doctor may recommend surgery.
Various types of surgical procedures are available. The surgical option recommended may depend on the severity of the valve damage. Some options involve open heart surgery or minimally invasive procedures.
In some cases, surgical repair of the tricuspid valve may be an option. The surgeon may tighten or reshape the flaps of the valve to stop the leaking. Surgical repair may also include patching any tears in the valve, which may help it close more efficiently.
If the surgeon cannot repair the valve, the doctor may suggest surgical tricuspid valve replacement. During the procedure, the surgeon removes the damaged valve and replaces it with a valve made from a pig, cow, human donor, or mechanical valve.
If left uncorrected, tricuspid regurgitation can progress to right heart failure in
Tricuspid regurgitation can lead to several cardiovascular complications if left untreated. Some complications may become life threatening.
Possible complications include:
People with tricuspid regurgitation should work closely with their doctor to develop a plan for living with the condition. Specific recommendations may vary.
However, in general, doctors recommend healthy lifestyle habits, such as
- maintaining a moderate weight
- developing healthy ways to manage stress
- getting regular exercise
- selecting heart-healthy foods
- quitting or avoiding smoking
Tricuspid regurgitation occurs when the tricuspid valve between the right atrium and right ventricle does not close as it should. This causes blood to leak backward into the right atrium. It most often occurs due to conditions that cause right ventricle enlargement.
If left untreated, tricuspid regurgitation can cause complications, such as heart failure. Treatment may include medication and surgery to repair or replace the tricuspid valve.