Tricuspid regurgitation
Tricuspid regurgitation is one of the types of heart disease in which there is a failure of the tricuspid (tricuspid) valve, leading during systole to reverse blood flow from the right ventricle into the atrium.
Tricuspid regurgitation: causes
Most often, the development of tricuspid valve regurgitation occurs against the background of heart disease, occurring with expansion of the right ventricle and pulmonary hypertension. Much less often this disease occurs against the background of septic endocarditis, rheumatism, carcinoid syndrome, Marfan syndrome. Insufficiency of the tricuspid valve may be a congenital pathology or develop as a result of prolonged use of certain medications (phentermine, fenfluramine, ergotamine).
Symptoms
With a slight defect in the tricuspid valve cusps (tricuspid regurgitation of the 1st degree), the disease usually does not manifest itself and is considered a benign condition that is not treated. Only a small proportion of patients experience pulsation of the cervical veins, caused by an increase in pressure in them.
With severe tricuspid valve regurgitation, there is marked swelling of the jugular veins. By placing your hand on the right jugular vein, you can feel its trembling. Significant valve insufficiency can lead to right ventricular dysfunction, atrial flutter or atrial fibrillation, and heart failure.
Tricuspid regurgitation: diagnosis
It is possible to make the correct diagnosis of tricuspid regurgitation, as well as determine the degree of the disease, on the basis of Doppler echocardiography data. In grade 1 tricuspid regurgitation, reverse blood flow from the right ventricle back to the right atrium is barely noticeable. Grade 2 tricuspid regurgitation is characterized by a reverse blood flow no more than 2.0 cm from the tricuspid valve. With the third degree of insufficiency, regurgitation exceeds 2.0 cm, and with the fourth, it spreads throughout the entire volume of the right atrium.
As additional research methods, ECG and chest x-ray are performed. On the electrocardiogram, signs of right ventricular hypertrophy are often revealed. On radiographs with tricuspid regurgitation grade 1, changes are usually not detected. With tricuspid regurgitation of grade 2 and higher, an enlarged shadow of the superior vena cava and right atrium is found, and in some cases, the presence of effusion in the pleural cavity.
Cardiac catheterization as a diagnostic method for tricuspid valve regurgitation is extremely rare.
Treatment for tricuspid regurgitation
Mild tricuspid valve regurgitation is well tolerated by humans and does not require treatment. Therapy is usually indicated for grade 2 to 4 tricuspid regurgitation. First of all, it is aimed at eliminating the cause that led to the development of tricuspid valve insufficiency (treatment of rheumatism, septic endocarditis, etc.). In addition, they also treat complications caused by tricuspid regurgitation - heart failure, arrhythmias.
In the absence of the effect of the conservative treatment carried out, as well as with the further progression of valve insufficiency, surgical intervention is indicated - prosthetics, plastic of the tricuspid valve or anuloplasty.
Anuloplasty is usually used when the disease develops due to dilatation (expansion) of the valve ring. Replacement of a tricuspid valve is indicated for its insufficiency caused by Epstein's defect or carcinoid syndrome. A porcine valve is used for the prosthesis, which makes it possible to significantly reduce the likelihood of thromboembolic complications in the postoperative period. As practice shows, the pig valve has been effectively functioning for more than 10 years, after which it is replaced with a new one.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
