Tricuspid regurgitation: A broken heart

What is Tricuspid Regurgitation?

The heart is a complicated piece of machinery. It pumps the blood of life into your body to make you live and breathe. In simple terms, it’s a pump that works forever as long as you live. But this pump is a system of chambers and valves. These valves are there to make sure that the heart doesn’t pump blood in the wrong direction.

In the right side of the heart, the chambers are divided as the upper right atrium and the lower right ventricle. The junction between these chambers is manned by a valve called the tricuspid valve. As the name itself suggests, the valve is composed of three cusps. This valve usually only allows blood to flow from the right atrium to the right ventricle, but sometimes blood leaks back in the other direction: from the right ventricle to the right atrium as a result of improper valve structure or function. This is called tricuspid regurgitation or tricuspid insufficiency.

How is it Caused?

You may get tricuspid regurgitation from birth, which is called “congenital,” or you may pick it up later in life, which are called “acquired” causes. At birth, some people have an anomaly called “Ebstein’s anomaly,” which occurs in approximately 1 in 200,000 live births, where the valve is displaced abnormally, causing regurgitation. Congenital connective tissue disorders such as Marfan’s syndrome and Ehlers-Danlos syndrome also may cause this.

With regard to acquired causes, rheumatic fever can damage the heart valves in a disease known as rheumatic carditis, and infection of the heart valves by microorganisms such as bacteria may also cause regurgitation. A heart tumor such as a myxomatous tumor may, in turn, cause this. However, the most common acquired cause, if there is no valve deformity, is due to dilatation of the right ventricle when it fills up with blood. This can occur if you have right heart failure or pulmonary hypertension (high blood pressure in your lungs).

Why Should You be Worried?

The mortality rate of this disease is approximately 10%. Severe tricuspid regurgitation causes filling up of blood and swelling of the right atrium. It may affect the liver causing cardiac cirrhosis and swelling of the abdomen, which is called ascites. A serious complication is that the stagnated blood in the right atrium may cause abnormal blood clots called thrombi which can later zip around the body and cause strokes or heart attacks.

What are the Signs and Symptoms?

Look for swelling in your abdomen or legs. You may feel fatigue or shortness of breath easily. Your neck veins may bulge and pulsate. Usually, most symptoms don’t present themselves until the condition is severe.

A doctor can catch this condition by using their stethoscopes and listening to heart sounds on the right side of the heart. If we find something called a systolic murmur on top of the valve site, it usually tells us that something is wrong with the valve. Afterwards, we can do an echocardiogram to look at your heart and confirm it. It is usually fixed by getting rid of an underlying condition such as right ventricular dilatation, or we can perform surgery to fix the valve, such as annuloplasty or valve replacement.

If you suspect that you might have this disease, don’t wait till it’s too late. Contact your doctor or contact us The Valve Clinic to find out your options.


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