TRICUSPIDREGURGITATIONAgnes KirongoJoanne MedinaScope:IntroductionSignsand symptomsDiagnosisManagementRemember: Frequently occurs in patients with pulmonary orcardiac disease, especially if pulmonaryhypertension is present. Holosystolic murmur along left sternal border,which increases with inspiration. Echocardiography useful in determining cause (lowor high-pressure tricuspid regurgitation).Thetricuspid valve apparatus differs from the mitral valveapparatus;Having three leaflets rather than two.Has many chordae that attach to the RV endocardium rather thanto discrete papillary muscles.Chordal attachments to the RV septum.Tricuspidvalvular incompetence often occurs whenever there is RVdilation from any cause. As tricuspid regurgitation increases, the RVsize increases further, and this in turn worsens the tricuspidregurgitation.Thecauses of tricuspid regurgitation usually relate toanatomic issues with either the valve itself or to theRV geometry.Anenlarged, dilated RV may be present if there ispulmonary hypertension for any reason, in severepulmonic regurgitation, or in cardiomyopathy.TheRV may be injured from myocardial infarction ormay be inherently dilated due to infiltrative diseases(RV dysplasia or sarcoidosis).TheRV dilation is often secondary to left heartInherent abnormalities of the tricuspidvalve include:Ebstein's anomaly (displacement of theseptal and po ...
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