Rheumatic tricuspid regurgitation

Rheumatic tricuspid regurgitation Rheumatic tricuspid regurgitation is almost always associated with mitral valve disease. Organic tricuspid regurgitation is often superimposed on hypertensive tricuspid regurgitation which occurs due to pulmonary arterial hypertension secondary to mitral valve disease. Tricuspid leaflets are thickened and deformed by the rheumatic process which leads to incomplete coaptation and tricuspid regurgitation. Clinically tricuspid regurgitation is manifest as prominent systolic wave in the jugular venous pulse (cv wave) and a pansystolic murmur in the tricuspid area, increasing on inspiration (Carvallo’s sign). Carvallo’s sign may be absent when there is severe heart failure. This is because there is no significant respiratory change when the right heart is already grossly congested. Similar situation occurs when there is associated tricuspid stenosis with high right atrial pressure. Systolic hepatic pulsations are felt in severe tricuspid regurgitation. Associated signs of pulmonary hypertension (palpable and loud pulmonary component of second heart sound or P2) and left parasternal heave due to right ventricular hypertrophy. Echocardiogram in severe tricuspid taken in the apical four chamber view Echocardiogram in severe tricuspid taken in the apical four chamber view: Severe tricuspid regurgitation (TR) is seen as a large mosaic (multi-colored) jet filling more than half of a dilated right atrium (RA). Right ventricle (RV) is also dilated...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: HBC cv waves De Vega procedure Source Type: blogs