Tricuspid valve stenosis
Encyclopedia
Tricuspid valve stenosis is a valvular heart disease
which results in the narrowing of the orifice of the tricuspid valve
of the heart
. It is a relatively rare condition that causes stenosis
- increased resistance to blood flow through the valve.
and is generally accompanied by mitral stenosis
.
Rare other causes include carcinoid syndrome
, endocarditis
, endomyocardial fibrosis, lupus erythematosus
, right atrial myxoma
and congenital tricuspid atresia
.
can be heard during auscultation
caused by the blood flow through the stenotic valve. It is best heard over the left sternal border with rumbling character and tricuspid opening snap with wide splitting S2. May increase in intensity with inspiration (Carvallo's sign
). The diagnosis and the severity can be assessed by echocardiography
.
The treatment is usually by surgery (tricuspid valve replacement
) or percutaneous balloon valvuloplasty. The resultant tricuspid regurgitation from percutaneous treatment is better tolerated than insufficiency occurring during mitral valvuloplasty
Valvular heart disease
Valvular heart disease is any disease process involving one or more of the valves of the heart . Valve problems may be congenital or acquired...
which results in the narrowing of the orifice of the tricuspid valve
Tricuspid valve
The tricuspid valve, or right atrioventricular valve, is on the right dorsal side of the mammalian heart, between the right atrium and the right ventricle. The normal tricuspid valve usually has three leaflets and three papillary muscles. They are connected to the papillary muscles by the chordae...
of the heart
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
. It is a relatively rare condition that causes stenosis
Stenosis
A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure.It is also sometimes called a stricture ....
- increased resistance to blood flow through the valve.
Causes
It is almost always caused by rheumatic feverRheumatic fever
Rheumatic fever is an inflammatory disease that occurs following a Streptococcus pyogenes infection, such as strep throat or scarlet fever. Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain, the illness typically develops two to three weeks after...
and is generally accompanied by mitral stenosis
Mitral stenosis
Mitral stenosis is a valvular heart disease characterized by the narrowing of the orifice of the mitral valve of the heart.-Signs and symptoms:Symptoms of mitral stenosis include:...
.
Rare other causes include carcinoid syndrome
Carcinoid syndrome
Carcinoid syndrome refers to the array of symptoms that occur secondary to carcinoid tumors. The syndrome includes flushing and diarrhea, and, less frequently, heart failure and bronchoconstriction...
, endocarditis
Endocarditis
Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves . Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or even on intracardiac devices...
, endomyocardial fibrosis, lupus erythematosus
Lupus erythematosus
Lupus erythematosus is a category for a collection of diseases with similar underlying problems with immunity . Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs...
, right atrial myxoma
Myxoma
A myxoma is a tumor of primitive connective tissue. It is the most common primary tumor of the heart in adults, but can also occur in other locations....
and congenital tricuspid atresia
Tricuspid atresia
Tricuspid atresia is a form of congenital heart disease whereby there is a complete absence of the tricuspid valve. Therefore, there is an absence of right atrioventricular connection. This leads to a hypoplastic or absent right ventricle....
.
Diagnosis
A mid diastolic murmurHeart murmur
Murmurs are extra heart sounds that are produced as a result of turbulent blood flow that is sufficient to produce audible noise. Most murmurs can only be heard with the assistance of a stethoscope ....
can be heard during auscultation
Auscultation
Auscultation is the term for listening to the internal sounds of the body, usually using a stethoscope...
caused by the blood flow through the stenotic valve. It is best heard over the left sternal border with rumbling character and tricuspid opening snap with wide splitting S2. May increase in intensity with inspiration (Carvallo's sign
Carvallo's sign
Carvallo's sign is a clinical sign found in patients with tricuspid regurgitation. The pansystolic murmur found in this condition becomes louder during inspiration; this sign enables it to be distinguished from mitral regurgitation.- Pathophysiology :...
). The diagnosis and the severity can be assessed by echocardiography
Echocardiography
An echocardiogram, often referred to in the medical community as a cardiac ECHO or simply an ECHO, is a sonogram of the heart . Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart...
.
Treatment
Tricuspid valve stenosis itself usually doesn't require treatment. However, if there is damage to other valves in the heart as well, then surgical repair or replacement must be considered.The treatment is usually by surgery (tricuspid valve replacement
Valve replacement
Valve replacement surgery is the replacement of one or more of the heart valves with either an artificial heart valve or a bioprosthesis . It is an alternative to valve repair.There are four procedures:...
) or percutaneous balloon valvuloplasty. The resultant tricuspid regurgitation from percutaneous treatment is better tolerated than insufficiency occurring during mitral valvuloplasty