Tricuspid Stenosis

Tricuspid stenosis is mostly associated with rheumatic heart disease. It occurs in 5% of patients with rheumatic heart disease. It rarely occurs in isolation; it is almost always associated with mitral and aortic valve disease.

It may also occur in the carcinoid syndrome.

Clinical features

• The main clinical feature is a raised JVP
• Symptoms of right heart failure, including right upper quadrant discomfort and peripheral oedema
• A mid-diastolic murmur is heard best at the left or right sternal edge. The murmur is high-pitched and increases on inspiration.
• Hepatomegaly may be present, with ascites and pedal oedema

*Symptoms of aortic and mitral valve disease will, however, usually predominate

Diagnosis;

1. Doppler echocardiography- gives a definitive diagnosis. It shows similar appearances to those of rheumatic mitral stenosis
2. Jugular venous pulse shows a prominent a wave and a slow y descent due to loss of the normal rapid right ventricular filling

Management

• Balloon valvuloplasty in the isolated cases
• A valve repair or valvotomy can be done in patients who require surgery for the other valves.