TRICUSPID STENOSIS INCOMPETENCE

CAUSATION OF TRICUSPID STENOSIS INCOMPETENCE

These are very rare and are of rheumatic, congenial or of functional origin. Tricuspid incompetence is commonly functional and is seen in association with right ventricular dilation. They almost never occur as isolate lesion. The haemodynamic alterations are like mitral stenosis and incompetence but here the burden exclusively falls on the right side of the heart. Clinically the pansystolic murmur of tricuspid incompetence and presystolic murmur of tricuspid stenosis are both heard best of the lower right or left sterna border and it is at times difficult to differentiate them from mitral murmurs.

TRICUSPID STENOSIS INCOMPETENCE

However, murmurs of tricuspid origin set intensified on inspiration (Carvallo’s sing). In tricuspid stenosis a tall ‘a’ wave and slow ‘y’ descent because of slow right ventricle filling is seen. In tricuspid incompetence prominent ‘cv’ waves are seen in jugular venous pulse. There is also associated rapid ‘y’ descent together with small or absent ‘x’ descent.Presystolic liver pulsation in the former and systolic liver pulsation in the latter conditions are also present. X-ray shows huge right atrial dilation.

Doppler study and MRI will also help in diagnosing chamber enlargement and anatomic defect. ECG shows right atrial hypertrophy in both types of cases but in addition in cases of tricuspid incompetence evidence of right ventricular enlargement will also be present. In tricuspid stenosis valvotomy may be required at times with prosthetic valve replacement. Balloon valvuloplasty may be the initial procedure of choice in many subjects.

In tricuspid regurgitation valvuloplasty or valve repair may often be required rather than valve replacement.

TRICUSPID STENOSIS INCOMPETENCE

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