A clinical Summary for students studying Medicine or science related subjects. The documents provide concise information on pathophysiology, Investigations and treatments on the chosen topic, which makes it ideal for exam revision.
Pathophysiology Examination &Investigations
Tricuspid stenosis is a rare condition that most commonly occurs as a
late complication of acute rheumatic fever. Examination
It is the narrowing of the tricuspid valve opening. Tricuspid stenosis
restricts blood flow between the atrium and ventricle part of the right Pulse – it’s unusual for patients to have normal pulse
side of the heart. however if it is then there’s a prominent jugular venous
alpha wave ( this is done by assessing the JVP) the patients
will complaint of pulsation in the neck & abdomen (over
liver) as well as getting other symptoms such as cough,
headaches & jaw pain.
Auscultations – rumbling mid-diastolic murmur – best heard
lower Lt sternal edge – louder on inhalation. A tricuspid snap
may also be heard
Hepatomegaly, abdominal ascites & oedema may also be
present
Investigations
CXR - Rt atrial bulge
ECG – Tall P waves (>3mm) in lead II – to show enlarged Rt
Risk Factors atrium. Atrial fibrillation seen in 50% of patients
Echocardiogram – may show thickened & immobile tricuspid
group A streptococcal (GAS) pharyngitis valve
metastatic carcinoid tumours
artificial tricuspid valve
intravenous drug use
Presenting Complaints & Symptoms
Pt usually complain of symptoms linked to Lt-sided rheumatic
value legions. This inc:
Treatments
Abdominal pain (due to hepatomegaly)
Sweeling (due to ascites)
Peripheral oedema – are severe Surgery – tricuspid valve replacement
Dyspnoea Other valves need also replacing because TS is rarely an
isolated lesion
Percutaneous balloon tricuspid dilatation has been
performed in a limited number of cases, either alone or
alongside percutaneous mitral commissurotomy, but this
frequently induces significant regurgitation. There is a lack of
data on evaluation of long-term results
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