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Tricuspid Valve Disease

Each year, millions of people are diagnosed with valve disease or a valve disorder. Valve disease occurs when the heart’s valves do not work correctly, causing the heart muscle to have to work harder to circulate the right amount of blood through the body.

What is tricuspid valve disease?
The tricuspid valve is located between the upper-right chamber (the right atrium) and the lower-right chamber (the right ventricle) of the heart and has three cusps, or flaps, that control the direction and flow of blood. When the right ventricle contracts, the tricuspid valve is supposed to pump blood forward into the lungs. If the valve does not close tightly, some of that blood leaks back into the heart's right atrium.

Valve disease can be caused by either regurgitation or stenosis: 

  • Tricuspid regurgitation. Tricuspid dilation is a progressive disease that eventually leads to severe tricuspid regurgitation (TR), which occurs when the tricuspid valve leaflets do not close properly, allowing blood to flow opposite of the intended direction. For patients with significant dilation of the tricuspid annulus (or opening), surgeons typically recommend surgical repair with an annuloplasty ring or band to restore the normal annular dimensions and normal leaflet closure, and to provide the necessary long-term support of the native annulus.
  • Tricuspid stenosis. Stenosis occurs when the valve(s) opening becomes narrowed or valves become damaged or scarred, inhibiting the flow of blood out of the heart’s ventricles or atria (the chambers of the heart). This restriction requires the heart to pump harder, which can strain the heart and reduce blood flow to the body.

What are the symptoms of tricuspid heart disease?
People with tricuspid valve disease usually have no symptoms. However, if symptoms do occur, they may include:

  • Difficulty breathing
  • Fatigue
  • Sensation of rapid or irregular heartbeat (palpitations)
  • Swelling of the legs, ankles, feet or abdomen
  • Weakness
  • Decreased urine output.

Many people can have symptoms of tricuspid regurgitation for years. If you have tricuspid regurgitation, you should see your doctor to find out if you have any underlying conditions that may contribute to the disease.

How is tricuspid valve disease diagnosed?
Physicians at the St. Francis Heart Valve Center work closely as a team to diagnose tricuspid valve disease. Your physicians will discuss your symptoms, review your family medical history, conduct a physical examination and order several tests to diagnose tricuspid valve disease and to develop an appropriate individuals treatment plan.

Diagnostic tests may include:

  • Cardiac catheterization. In this procedure, your cardiologist will insert a long, thin tube (catheter) into a blood vessel in your arm or groin and thread it to your heart using X-ray imaging. Sometimes, your doctor may inject a dye into the arteries for visible under X-ray imaging (angiogram).
  • Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create a detailed image of your heart. · Echocardiogram. In this test, sound waves are produced to create detailed images to see how the tricuspid valve and the blood flow through your heart. Your physicians also may order a three-dimensional (3-D) echocardiogram.
  • Electrocardiogram (ECG). In this test, sensor patches with wires attached (electrodes) measure the electrical impulses given off by your heart. An ECG detects any abnormal heart rhythm.
  • Electrophysiology tests. Your physicians may conduct electrophysiology tests if you have an abnormal heart rhythm. In an electrophysiology test, a physician inserts long, thin tubes (catheters) with sensors (electrodes) at the tips into an artery in your groin and threads them to your heart using X-ray imaging. The electrodes can precisely map the spread of electrical impulses through your heart.
  • Holter monitor. A Holter monitor is a portable ECG device you wear for a day or more to record your heart's electrical activity during your daily routine.
  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields and radio waves to create detailed images of your heart.
  • Stress tests. A stress test helps measure your activity tolerance and monitor your heart's response to physical exertion.
  • Transesophageal echocardiogram. In this test, your cardiologist will insert a tube with a tiny sound device into your esophagus, which lies close to your heart. The device provides a more detailed image of the tricuspid valve and blood flow through the tricuspid valve.