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Tricuspid Valve Disorders

What are tricuspid valve disorders?
What are the symptoms of tricuspid valve disorders?
What causes tricuspid valve disorders?
How are tricuspid valve disorders diagnosed?
How can tricuspid valve disorders be treated?

What are tricuspid valve disorders?

The tricuspid valve is one of your heart's four valves; it controls the flow of blood between the atrium (the upper chamber) and the ventricle (the lower chamber) on your heart's right side. A valve is several little flaps of tissue that open and close each time your heart beats, sending blood in the correct direction—in the case of your tricuspid valve, out of your right atrium and into your right ventricle. When it's working as it should, the flaps of the tricuspid valve open to allow the atrium to pump blood down into the ventricle, then close again while the ventricle pumps blood out of the heart, to keep blood from flowing back up to the atrium.

Disorders of the tricuspid valve are often associated with problems of the mitral valve. The following conditions are among those that can affect the function of the tricuspid valve:

  • Tricuspid valve regurgitation, which means your tricuspid valve is leaky and allows blood to flow backward into the right. ("Regurgitation" comes from Latin words meaning "to engulf again.")
  • Tricuspid valve stenosis, which means the flaps of the valve have thickened, stiffened or stuck together and are thus unable to open completely; this partially blocks the flow of blood from the right atrium to the right ventricle. ("Stenosis" comes from a Latin word meaning "to make narrow.")
  • Ebstein's anomaly, a rare congenital defect, present from birth, in which the flaps of the tricuspid valve are improperly formed and/or placed. This often causes the blood to flow backward from the ventricle into the atrium. In addition, Ebstein's anomaly is often accompanied by another congenital condition known as an atrial septal defect, or a hole between the two upper chambers of the heart.
  • Tricuspid valve atresia, also a rare congenital defect, present from birth, in which the tricuspid valve is missing. ("Atresia" comes from Greek words meaning "without an opening.") In addition, tricuspid valve atresia is often accompanied by another congenital condition known as a ventral septal defect, or a hole between the two lower chambers of the heart. The heart is sometimes able to compensate for this deficiency, but it often requires surgical repair.

Some people with a tricuspid valve disorder experience few or no symptoms. But in some cases, if the condition is not treated it can result in serious complications, including endocarditis, an inflammation of the lining and valves of the heart, or congestive heart failure.

What are the symptoms of tricuspid valve disorders?

Symptoms of a disease are indications that can be detected by the patient, such as pain or fatigue (while signs are indications that can be detected by a doctor, such as the results of a blood test or an X-ray). Some people with tricuspid valve disorders experience no symptoms. If symptoms do occur, they often come on gradually.

The symptoms of tricuspid valve regurgitation or stenosis are similar and include a pulsing of the veins in your neck; a decreased output of urine; fatigue or tiredness; shortness of breath; swelling of your feet, ankles or abdomen; and weakness.

The symptoms of Ebstein's anomaly include these symptoms, as well as cyanosis, a bluish tinge to the skin, lips and fingernails, caused by incomplete oxygenation of the blood; dizziness; or an abnormal heart rhythm. And additional symptoms of tricuspid valve atresia can include cyanosis, rapid breathing, or heavy sweating.

What causes tricuspid valve disorders?

Image of EKG Some disorders of the tricuspid valve are congenital defects, present from birth. In most cases of congenital heart defects, there is simply no way of knowing what caused them.

Tricuspid valve regurgitation, however, is most often caused by pulmonary hypertension (high blood pressure in the lungs, often as a result of a leaky or narrowed mitral valve). It can also be caused by endocarditis (an inflammation of the lining and valves of the heart); heart failure; a heart attack, or myocardial infarction; or trauma, such as from a car accident.

How are tricuspid valve disorders diagnosed?

If a damaged tricuspid valve is symptomless, it can sometimes be identified during a routine physical exam. For example, if your doctor detects signs such as a heart murmur (a "swooshing" sound perceptible through a stethoscope), it may lead to a suspicion of a tricuspid valve disorder.

If such signs—or the presence of symptoms—cause your doctor to suspect that you may have a damaged tricuspid valve, certain diagnostic tests will likely be conducted. They may include an angiogram (also referred to as cardiac catheterization), which uses opaque dye to image your cardiovascular system; a chest X-ray; an electrocardiogram (also referred to as an ECG or EKG), which measures and records your heart's electrical activity; an echocardiogram (an ultrasound image of your chest); or an MRI of your heart.

How can tricuspid valve disorders be treated?

No treatment may be needed if a disorder of the tricuspid valve is mild and causes no symptoms. For symptomatic disorders of the tricuspid valve, medications—such as drugs that improve the blood flow, reduce the likelihood of blood clots, or stabilize an abnormal heartbeat, as well as diuretics, which reduce the fluid buildup in your tissues—may relieve some symptoms and delay the development of complications.

In the case of a seriously damaged tricuspid valve, however, surgery may be indicated. While there are risks to surgery, they need to be balanced against the risks that your valvular disease will progress otherwise.


Page reviewed on: Jun 26, 2015

Page reviewed by: Jock McCullough, MD

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