What is Tricuspid valve regurgitation – Symptoms and causes

October 25, 2024

Share the article

What is Tricuspid valve regurgitation – Symptoms and causes

Tricuspid valve regurgitation is also called tricuspid insufficiency. It is a kind of valvular heart disease where the tricuspid valve of the heart which is located between the right atrium and right ventricle does not close completely when the right ventricle contracts.

What is Tricuspid Valve Regurgitation?

It is a type of heart valve disease where the valve’s flaps (cusps or leaflets) do not close properly. The tricuspid valve controls the blood flow from the heart’s right upper chamber (atrium) to the heart’s right bottom chamber (right ventricle). When this does not function properly, blood can leak backward into the atrium through the leaky tricuspid valve. As a result, your heart has to pump harder to move blood through the valve. If you have tricuspid valve regurgitation, less blood flows to your lungs.

Symptoms of Tricuspid Valve Regurgitation

Unless the condition is severe, symptoms of tricuspid regurgitation are normally not noticed. Symptoms could include:

Fatigue: feeling unusually tired during physical activity
Swelling: There may be a noticeable swelling in the abdomen, legs, neck, or veins.
Abnormal heart rhythms: You may feel like your heart is beating too slowly, too quickly, or irregularly.
Pulsing in your neck: There may be pronounced throbbing in the veins in your neck
Shortness of breath: You may have trouble breathing deeply during exercise

Causes of Tricuspid Valve Regurgitation

There could be various causes of tricuspid valve regurgitation.

A congenital heart defect: You may be born with a defect that affects the shape and functioning of the tricuspid valve. It is also caused in children by a rare heart problem present at birth called Ebstein anomaly. The valve itself is not formed correctly. It is formed lower than usual in the lower ventricle.
Marfan syndrome: Changes in the genes cause this condition. It affects the fibres that support and anchor the organs and other structures in the body.
Rheumatic fever: An autoimmune disease that can occur after a bacterial infection such as strep throat or scarlet fever. It can cause permanent damage to the heart and valves. When this happens, it is called rheumatic heart valve disease.
Infection of the heart valves and lining: This condition is also called infective endocarditis. The infection damages the tricuspid valve. Misuse of IV drugs can cause this.
Carcinoid syndrome: Sometimes, a rare cancerous tumour releases certain chemicals into the bloodstream. This can lead to carcinoid heart disease. Mostly the tricuspid valves and the pulmonary valves are commonly damaged.
Chest injury: An injury from a car accident for instance can cause this condition.
Pacemaker or other heart device wires: Sometimes, the wires from a pacemaker may cross the tricuspid valve. This may be a cause for the condition.
Heart biopsy: Sometimes a small part of the heart muscle tissue is removed for examination. This is called an endomyocardial biopsy and it can damage the tricuspid valve.
Radiation therapy: Rarely, radiation therapy for cancer when focused on the chest area can cause tricuspid valve regurgitation.

Diagnosis and Treatment

Tricuspid valve regurgitations occur silently and are normally diagnosed when imaging tests are being done on the heart for other reasons. The cardiologist will ask you about your symptoms and your medical history. When the doctor listens to your heart using a stethoscope, they may hear a wooshing sound called a heart murmur.

Tests to diagnose a tricuspid valve regurgitation may include:

Echocardiogram: This is the main test that is used in diagnosis. Using sound waves, it creates pictures of the beating heart. It shows how blood flows through the heart and heart valves including the tricuspid valve. A standard echocardiogram creates pictures of the heart from outside the body. This is called transthoracic echocardiogram (TTE). Sometimes, when more details are required, then a test called transoesophageal cardiogram (TEE) is used to create pictures of the heart from inside the body.

Electrocardiogram: This records the electrical signals in the heart and shows how the heart is beating. Electrodes are stuck to the chest, hands, and legs. Wires connect the sensors to the computer which displays and prints the results.

Chest X-ray: An X-ray showing the heart and lungs

Cardiac MRI: magnetic fields and radio waves are used to create detailed pictures of the heart. A cardiac MRI shows the severity of the tricuspid valve regurgitation and details about the lower, right, heart chamber.

Cardiac catheterization: A thin flexible tube called a catheter is inserted through a blood vessel in the arm or groin. It is slowly moved to the artery in the heart. The tube has a dye that makes the arteries of the heart show clearly on an X-ray which is taken during the test. Pressure in the heart is also measured during this test.

Treatment depends on the cause of the tricuspid valve regurgitation. You may be advised:

Medicines: Usually, medications to prevent water retention and control your heart rate are given.
A heart procedure
Surgery to repair or replace the valve: This surgery is done either as an open-heart surgery or a minimally invasive heart surgery. Cardiac catheterization can help improve blood flow and reduce the symptoms of the disease. Surgery is performed if the disease is severe, your heart is growing larger or weaker or you need heart surgery for another condition called mitral valve disease.

Living with Tricuspid Valve Regurgitation

Your prognosis will depend on your overall health and disease progression. You will have to manage your health and lifestyle based on the doctor’s advice. You will be advised based on the severity of your disease. Among many things, they may tell you:

Have a healthy heart diet
Avoid smoking
Regular exercise routine. Those who have had heart failure will be advised to avoid strain on the heart.
Medication prescribed by the doctor
Regular monitoring by the healthcare provider
Visit the dentist regularly and maintain good oral health
If you have strep throat, see the doctor immediately

Conclusion

If you get tired very easily or feel short of breath with activity, see a doctor immediately. It is important to inform all your healthcare providers, including your dentist that you have tricuspid valve regurgitation. Mild tricuspid valve regurgitation might not be serious, but severe conditions will require immediate attention from a cardiologist.

Frequently Asked Questions

1. What is tricuspid valve regurgitation?

It is a heart valve disease that occurs when the tricuspid valve doesn’t close properly. This allows the blood to flow backward into the right atrium when the right ventricle contracts.

2. What are the symptoms of tricuspid valve regurgitation?

Symptoms include fatigue, tiredness, and swelling in the abdomen, feet, and ankles. A feeling of a rapid or pounding heartbeat.

3. What causes tricuspid valve regurgitation?

Mostly, an increase in the size of the right ventricle can be caused by many things including high BP in the lungs, infections, and other heart problems. People are sometimes born with the defect.

4. How is tricuspid valve regurgitation diagnosed?

A transthoracic echocardiogram is used to evaluate the severity of tricuspid valve regurgitation. Sometimes a chest X-ray, EKG, and cardiac MRI are used.