Tricuspid insufficiency

The health care provider may find abnormalities when gently pressing with the hand (palpating) on your chest. The doctor may also feel a pulse over your liver. The physical exam may show liver and spleen swelling.

Listening to the heart with a stethoscope may reveal a murmur or other abnormal sounds. There may be signs of fluid collection in the abdomen.

An ECG or echocardiogram may show enlargement of the right side of the heart. Doppler echocardiography or right-sided cardiac catheterization may be used to measure blood pressure inside the heart and lungs.

Other tests, such as CT scan or MRI of the chest (heart), may reveal enlargement of the right side of the heart and other changes.

Treatment may not be needed if there are few or no symptoms. You may need to go to the hospital to diagnose and treat severe symptoms.

Swelling may be managed with medications (diuretics) that help remove fluids from the body.

Conditions that cause this problem should be identified and treated. Some people may be able to have surgery to repair or replace the tricuspid valve. Surgery is usually done as part of another procedure.

People with abnormal or damaged heart valves are at risk for an infection called endocarditis. Anything that causes bacteria to get into your bloodstream may lead to this infection. Steps to avoid this problem include:

• Avoid unclean injections
• Treat strep infections promptly to prevent rheumatic fever
• Always tell your health care provider and dentist if you have a history of heart valve disease or congenital heart disease before treatment. Guidelines recommend the use of antibiotics for some patients, but only under certain conditions.

Treating any conditions, especially high blood pressure in the lungs and swelling of the right lower heart chamber, may correct this disorder. Surgical valve repair or replacement usually provides a cure. However, persons with severe tricuspid regurgitation that cannot be corrected may have a poor prognosis, either from this condition or the one that caused it.

• Cirrhosis
• Endocarditis
• Weight loss
• Worsening of heart failure

Call your health care provider if symptoms of tricuspid regurgitation are present.

Prompt treatment of disorders that can cause valve disease reduces your risk of tricuspid regurgitation.

Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 75.

Nishimura RA, Carabello BA, Faxon DP, et al. ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(8):676-685.

Otto CM, Bonow RO. Valvular heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. St. Louis, Mo: WB Saunders; 2011:chap 66.