What to know about tricuspid stenosis

Definition of tricuspid stenosis

Tricuspid stenosis is a rare condition that affects a person’s tricuspid valve. People often have tricuspid stenosis together with other heart conditions. It affects fewer than 3 in 100 people worldwide.

The heart contains four valves that allow blood to flow through the heart in the right direction. Stenosis of the heart valves describes a narrowing of the heart valves, which can restrict blood flow.

The tricuspid valve sits between a person’s lower right heart chamber and their upper right heart chamber. These chambers are known as the right ventricle and right atrium. The tricuspid valve helps blood to flow from the right atrium to right ventricle. It also stops blood flowing backward.

A person with tricuspid stenosis has a narrowed tricuspid valve opening. This restricts blood flow between a person’s right atrium and right ventricle. This can lead to symptoms and complications.

Symptoms of tricuspid stenosis

Symptoms of tricuspid stenosis are usually mild. They can include:

• heart palpitations, feelings of having a fluttering or pounding heart
• fluttering discomfort in a person’s neck
• swelling in a person’s legs
• having cold skin
• feeling tired or generally weak
• loss of appetite and weight loss
• a feeling of running out of air, and not being able to breathe fast or deeply enough during physical activity
• loss of consciousness during or immediately after physical activity

Complications from tricuspid stenosis can include:

• atrial fibrillation, an irregular and often fast heartbeat
• heart failure
• liver failure
• infective endocarditis, an inflammation of the inner lining of a person’s heart normally resulting from bacteria

However, healthcare professionals can minimize a person’s risk of these complications with early treatment and monitoring.

Causes and risk factors for tricuspid stenosis

A common cause of tricuspid stenosis is rheumatic valvulitis. This is inflammation and damage resulting from rheumatic fever, a complication of having a bacterial infection known as strep throat. However, rheumatic fever is rare and usually avoidable if a person receives proper medical treatment.

Other and rare causes of tricuspid stenosis include:

• infective endocarditis
• damage during:
  • surgery to implant a pacemaker
  • heart biopsies, a surgical procedure where healthcare professionals take a small sample of a person’s heart muscle tissue for testing
• systemic lupus erythematosus, a condition that affects a person’s immune system, also known as lupus
• antiphospholipid antibody syndrome, a condition where a person’s immune system creates antibodies that attack their own body
• heart tumors
• chest radiation during some cancer treatments
• metabolic conditions such as Fabry and Whipple diseases, which affect how a person’s body breaks down food

In very rare cases, a person may have tricuspid stenosis due to birth problems.

Diagnosis of tricuspid stenosis

People with tricuspid stenosis may have subtle symptoms or symptoms that overlap with other heart conditions. Healthcare professionals, therefore, can use a variety of testing and scans to accurately diagnose tricuspid stenosis. These include:

• echocardiogram, which is a type of ultrasound scan that shows the heart and nearby blood vessels
• laboratory tests, including:
  • metabolic panels to measure several aspects of a person’s blood
  • arterial blood gas tests, which measure the amount of oxygen and carbon dioxide in a person’s blood
• chest X-rays
• electrocardiogram (ECG) to record electrical activity in the heart
• jugular venous pulse tracing to measure pressure inside the heart
• cardiac catheterization, which is when a doctor inserts a long, flexible tube into a person’s heart to take measurements or samples

Treatment of tricuspid stenosis

If a person’s tricuspid stenosis is severe enough, healthcare professionals may repair or replace their tricuspid heart valve. They determine the best treatment option for a person on the basis of their risks from surgery and other health or heart conditions.

Surgeons often treat a person’s tricuspid stenosis using procedures including a balloon valvuloplasty, also known as an endovascular valvotomy. This is a procedure where a surgeon inserts a small catheter holding an expandable balloon into the correct place in a person’s heart. They then expand the balloon to open the valve and repair it.

Healthcare professionals may also use medication such as loop diuretics to help relieve a person’s symptoms. Loop diuretics help a person’s kidneys to remove more water and salt from their blood. This helps to reduce the workload on a person’s heart, which can relieve symptoms and avoid further problems.

Summary

A person’s tricuspid valve helps blood to flow correctly from the right atrium to the right ventricle. If a person has tricuspid stenosis, their tricuspid valve narrows. They then have reduced blood flow through their heart.

The most common cause of tricuspid stenosis is valve damage resulting from rheumatic fever. A person with tricuspid stenosis may have several symptoms, usually mild. They can, however, also develop more serious complications, including heart failure.

If a person’s tricuspid stenosis is severe, healthcare professionals will usually use surgery to repair or replace their tricuspid valve. They may also be able to use medication to help relieve symptoms.