Internal Medicine

0521779407-20 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:22

1450 Tricuspid Valve Insufficiency (TR) Tricuspid Valve Stenosis (TS)

specific therapy

n/a

follow-up

n/a

complications and prognosis

■Absence of pulmonary artery hypertension – prognosis good

■Presence of pulmonary artery hypertension – prognosis depends on

primary condition

TRICUSPID VALVE STENOSIS (TS)

JUDITH A. WISNESKI, MD

history & physical

Etiology

■Isolated TS not common

■Rheumatic heart disease (almost never isolated TS,but associated

with mitral

➣and aortic valve disease)

■Carcinoid syndrome (usually tricuspid insufficiency,TS rare)

History

■Symptoms of right heart failure: fatigue, elevated JVP, hepatomegaly,

ascites, peripheral edema

■Symptoms associated with other valvular disease

■Flushing and diarrhea: carcinoid syndrome

Signs & Symptoms

■PMI – normal

■JVP – elevated

■Diastolic rumble right sternal border or lower left sternal border,

increases

➣with inspiration or leg raising

■Opening snap varies with respiration

■P2-normal

■Hepatic enlargement, ascites

■Peripheral edema