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.
Tricuspid regurgitation is leakage of blood backwards through the Examination
tricuspid valve each time the right ventricle contracts – as the valve
doesn’t close properly. Auscultations - between S1-S2 you will hear a flushing-
rushing sounds a ‘turbulent flow’ known as a hollow systolic
As the right ventricle contracts to pump blood forward to the lungs, flow. This is best heard on inspiration because more blood
some blood leaks backward into the right atrium, increasing the flows through the Rt-side of the heart and increases intensity
volume of blood in the atrium. As a result, the right atrium can of the murmur – this is called carvalo’s sign.
enlarge, which can change the pressure in the nearby chambers and
blood vessels and leads to Right-side heart failure (HF)
Risk Factors
CVD risk factors
Infected endocarditis (as it can injure the tricuspid valve) Investigations
Marfan syndrome (less common) Echocardiogram – you will look for the regurgitation Jet for
Rheumatoid arthritis the right ventricle to the right atrium during ventricular
Rhematic fever systole. This test can tell you about aetiologies for example
Injury eroded valves if they have infected endocarditis.
Permeant pacemakers
Weight-loss diet medications (phentermine and
fenfluramine – also called ‘Fen-Phen’
Presenting Complaints & Symptoms
Tricuspid regurgitation may not have symptoms or the symptoms may
be vague, such as weakness and fatigue. These symptoms develop
because the heart is not pumping enough blood to allow the body to
receive the needed oxygen.
Treatments
Other symptoms may include:
If the patient has Right-side HF due to the tricuspid valvular diseases
– you will want to relieve the congestion by:
Key diagnostic factors
Fluid restriction – to avoid overloading of the heart as it will
Fatigue or weakness
make it work harder
Abdominal swelling
Restrict Na- to minimize extra fluid around the heart
Palpitations
Dieresis - such as furosemide, if they have oedema or asities
Presence of risk factors
Swelling in the legs, ankles, and/or feet
Unexplained fatigue Surgery
Pulsing in the neck
Decreased urine output Valve replacement using mechanical suitable for patients
Active pulsing in the neck veins with history of atrial fibrillation and <65yrs old and low risk
Enlarged liver of bleeding as lifelong anticoagulation required – lost lasting
It’s important to note that a lot of these patients can present Bioprosthetic - don’t require anticoagulation for life only 3
with symptoms of Rt-side HF months and more suitable for >65 yrs old & those with high
risk of bleeding. However have high risk of developing
prosthetic value endocarditis therefore amoxicillin required
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