Tricuspid Valve Diseases

Tricuspid Valve Stenosis: The tricuspid valve may become stenotic as a result of rheumatic fever, or it may be narrow at birth.  Tricuspid valve stenosis from rheumatic fever is relatively uncommon. It is usually associated with mitral valve stenosis. If the valve is severely narrowed, blood returning from the veins to the heart will have difficulty leaving the right atrium to the right ventricle. As a result, the liver may become engorged, and fluid can build up in the abdomen. This fluid buildup is known as ascites. The legs and ankles may swell.

Diagnosis: echocardiography will diagnose the narrowed valve. Abdominal ultrasound can be used to detect the fluid in your abdomen and to give idea about liver affection.

Treatment: Medical treatment involves using diuretics (water pills), removal of ascitic fluid from your abdomen (tapping). Heart surgery may be required to split this valve open and sometimes the valve is excised and replaced with a bioprosthetic valve.

Tricuspid Valve Incompetence:

Tricuspid valve incompetence is relatively common and usually related to dilatation of the tricuspid valve annulus, or the ring around the tricuspid valve that anchors the valve. This is commonly related to either long-standing mitral valve disease or pulmonary arterial and/ or pulmonary venous hypertension, meaning the pressure in the pulmonary arteries and veins is elevated, forcing the right ventricle to work harder. Over time, the right ventricle enlarges and begins to fail. As it does, the annulus may dilate and cause the tricuspid valve to leak blood back into the right atrium, causing similar signs and symptoms as in tricuspid valve stenosis (narrowed valve). Depending on the severity of the condition, heart surgery may be required, and the valve may be repaired or replaced

During an episode of endocarditis , bacteria or fungi can destroy the leaflets of the tricuspid valve. When a tricuspid valve is severely damaged because of antibiotic-resistant infection and the infection is the result of illicit intravenous drug abuse, a good method of treatment is to remove the infected tricuspid valve and not replace it. This removes the source of the infection. If an artificial valve is put in, it too will likely become infected since the patient frequently resumes the illicit drug use.

Tricuspid Valve Stenosis and Incompetence

This combination is usually related to rheumatic heart disease, and the problem is similar to mitral and aortic valve incompetence/stenosis in which the valve is both leaky and narrow. Depending on its severity, this condition may require heart surgery.