Tricuspid valve stenosis

Tricuspid valve stenosis
Classification and external resources
Specialty	Cardiology
ICD-10	I07.0, I36.0, Q22.4
ICD-9-CM	397.0, 746.9
eMedicine	med/2315
MeSH	D014264

Tricuspid valve stenosis is a valvular heart disease which results in the narrowing of the orifice of the tricuspid valve of the heart. It is a relatively rare condition that causes stenosis- increased resistance to blood flow through the valve.

Causes

It is almost always caused by rheumatic fever^[1] and is generally accompanied by mitral stenosis.

Rare other causes include carcinoid syndrome, endocarditis, endomyocardial fibrosis, lupus erythematosus, right atrial myxoma and congenital tricuspid atresia.

Diagnosis

A mid diastolic murmur can be heard during auscultation caused by the blood flow through the stenotic valve. It is best heard over the left sternal border with rumbling character and tricuspid opening snap with wide splitting S1. May increase in intensity with inspiration (Carvallo's sign). The diagnosis and the severity can be assessed by echocardiography.

Treatment

Tricuspid valve stenosis itself usually doesn't require treatment. However, if there is damage to other valves in the heart as well, then surgical repair or replacement must be considered.

The treatment is usually by surgery (tricuspid valve replacement) or percutaneous balloon valvuloplasty. The resultant tricuspid regurgitation from percutaneous treatment is better tolerated than insufficiency occurring during mitral valvuloplasty

References

↑ "Tricuspid Stenosis: Overview - eMedicine Cardiology". Retrieved 2009-03-06.

External links

Echocardiographic features of tricuspid stenosis

Cardiovascular disease (heart) (I00–I52, 390–429)

Ischaemic

Coronary disease	Coronary artery disease (CAD) Coronary artery aneurysm Spontaneous coronary artery dissection (SCAD) Coronary thrombosis Coronary vasospasm Myocardial bridge

Active ischemia	Angina pectoris Prinzmetal's angina Stable angina Acute coronary syndrome Myocardial infarction Unstable angina

Sequelae	hours Hibernating myocardium Myocardial stunning days Myocardial rupture weeks Aneurysm of heart / Ventricular aneurysm Dressler syndrome

Layers

Pericardium

Myocardium

Endocardium /
valves

Endocarditis	infective endocarditis Subacute bacterial endocarditis non-infective endocarditis Libman–Sacks endocarditis Nonbacterial thrombotic endocarditis

Valves	mitral regurgitation prolapse stenosis aortic stenosis insufficiency tricuspid stenosis insufficiency pulmonary stenosis insufficiency

Conduction /
arrhythmia

Bradycardia

Tachycardia
(paroxysmal and sinus)

Supraventricular	Atrial Multifocal Junctional AV nodal reentrant Junctional ectopic

Ventricular	Accelerated idioventricular rhythm Catecholaminergic polymorphic Torsades de pointes

Premature contraction

Pre-excitation syndrome

Flutter / fibrillation

Other / ungrouped

Other

Congenital heart defects (Q20–Q24, 745–746)

Cardiac shunt/
heart septal defect

Aortopulmonary septal defect	R→L: Double outlet right ventricle Taussig–Bing syndrome Transposition of the great vessels dextro levo Persistent truncus arteriosus Aortopulmonary window

Atrial septal defect	L→R: Sinus venosus atrial septal defect Lutembacher's syndrome

Ventricular septal defect	L→R and R→L: Eisenmenger's syndrome R→L, with other conditions: Tetralogy of Fallot

Atrioventricular septal defect	L→R: Ostium primum

Valvular heart disease/
heart chambers

Right	pulmonary valves stenosis insufficiency tricuspid valves stenosis atresia Ebstein's anomaly Hypoplastic right heart syndrome Uhl anomaly

Left	aortic valves stenosis insufficiency bicuspid mitral valves stenosis regurgitation Hypoplastic left heart syndrome