Overview
Diagnosis
Tricuspid valve regurgitation can occur without noticeable symptoms and may be detected during heart imaging for other reasons. A healthcare professional examines you, asks about your symptoms and medical history, and listens to your heart with a stethoscope. A whooshing sound, called a heart murmur, may indicate valve leakage.
Tests to diagnose tricuspid valve regurgitation include:
• Echocardiogram – The main test to visualize heart structure and blood flow through the tricuspid valve. Types include transthoracic echocardiogram (TTE) from outside the body and transesophageal echocardiogram (TEE) for a detailed internal view.
• Electrocardiogram (ECG or EKG) – Records electrical activity to detect irregular heartbeats.
• Chest X-ray – Shows the size and condition of the heart and lungs.
• Cardiac MRI – Provides detailed images of the heart and lower right heart chamber, helping assess disease severity.
• Cardiac catheterization – Rarely used for diagnosis, this test measures pressures in the heart and may identify causes if other tests are inconclusive.
Staging
Heart valve disease is staged to guide treatment decisions:
• Stage A: At risk – Risk factors are present.
• Stage B: Progressive – Mild or moderate valve disease without symptoms.
• Stage C: Asymptomatic severe – Severe valve disease without symptoms.
• Stage D: Symptomatic severe – Severe valve disease with noticeable symptoms.
Treatment
Treatment for tricuspid valve regurgitation depends on the cause, severity, and symptoms. The main goals are to improve heart function, reduce symptoms, enhance quality of life, and prevent complications.
Medications
Medicines may be used to control symptoms or treat the underlying cause:
• Diuretics – Reduce fluid buildup by increasing urination.
• Potassium-sparing diuretics (aldosterone antagonists) – May improve survival in heart failure.
• Medicines for heart failure or irregular heartbeats, such as atrial fibrillation.
• Supplemental oxygen – May be given for pulmonary hypotension.
Surgeries or procedures
Surgical or catheter-based procedures may be needed for severe tricuspid valve regurgitation:
• Tricuspid valve repair – Open-heart, minimally invasive, or catheter-assisted techniques restore valve function. Repair may involve patching, reshaping, or repositioning valve flaps. The cone procedure is used for Ebstein anomaly.
• Tricuspid valve replacement – The valve is replaced with mechanical or biological tissue valves. Mechanical valves require lifelong blood thinners, while biological valves may wear down over time and need replacement.
• Valve-in-valve replacement – A catheter procedure replaces a failing biological tissue valve without open-heart surgery.
Some people may only require regular checkups if the regurgitation is mild and not causing symptoms.
Pregnancy
Regular and careful monitoring is essential for pregnant individuals with tricuspid regurgitation. In some cases, pregnancy may be discouraged to reduce the risk of complications, including heart failure.
After repair or replacement, ongoing checkups are necessary to ensure optimal heart function and overall health.
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