0521779407-20 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:22
1448 Trichuriasis Tricuspid Valve Insufficiency (TR)■Contraindications: absolute: Pregnancy if light infection. Hold treat-
ment to second or third trimester if heavy infection (heavy infections
rare in adults), and use mebendazole.
■Contraindications: relative: none
follow-up
Routine
■Usually not needed, since a few remaining worms are not clinically
significant. Repeat O&P can be done.
complications and prognosis
■Recovery is the rule. Untreated worms die off within 4–5 years. Severe
cases in children can cause rectal prolapse.TRICUSPID VALVE INSUFFICIENCY (TR)
JUDITH A. WISNESKI, MD
history & physical
Etiology
■Secondary due to right ventricular dilatation due to pressure or vol-
ume overload (most common)
➣Left ventricular systolic or diastolic dysfunction
➣Mitral stenosis
➣Cor pulmonale
➣Primary pulmonary hypertension
➣Pulmonic stenosis
➣Left to right shunt
■Primary due to structural damage to tricuspid valve
➣Endocarditis (most common primary etiology)
➣Carcinoid syndrome
➣Rheumatic heart disease
➣Right ventricular infarct
➣Ebstein’s anomaly
➣Trauma
History
■Symptoms
➣Right ventricular failure
Signs & Symptoms
■Right ventricular lift