What is the tricuspid valve?
The tricuspid valve is the inlet valve on the right circuit. It opens to let blood flow from the right atrium to right ventricle, then closes to stop blood flowing backwards. The tricuspid valve consists of three leaflets. This valve is thinner and more delicate than the mitral valve and a little tricuspid regurgitation is normal and more common than normal mitral regurgitation.
What is tricuspid regurgitation?
Tricuspid regurgitation is a condition where the valve between the right atrium and the right ventricle is leaking. When the right ventricle contracts all the blood should be rooted out of the heart towards the lungs via the pulmonary valve. In tricuspid regurgitation instead of all the blood exiting the heart the correct way via the pulmonary valve, some blood leaks backwards across the leaking tricuspid valve (which should be shut) back into the top chamber known as the right atrium.
What causes tricuspid regurgitation?
Mild tricuspid regurgitation is very common and should be considered normal. Moderate tricuspid regurgitation is also very common and often related to age-related changes. Severe tricuspid regurgitation can be caused by a stretch on the right side of the heart related to lung disease or a stretch on the top chamber of the heart known as the right atrium. The valve itself can be abnormal but this is quite unusual.
How is tricuspid regurgitation detected?
Tricuspid regurgitation is diagnosed following a cardiac ultrasound (echocardiogram). Most people who are diagnosed with this condition find out that they have it by chance, when they have a cardiac ultrasound (echocardiogram,) for other reasons. In some cases, the doctor may have heard a murmur or arranged tests due to symptoms such as ankle swelling or shortness of breath.
What are the symptoms of tricuspid regurgitation?
Most people with tricuspid regurgitation will not experience any symptoms. If the valve is severely leaky then symptoms such as exertional shortness of breath, swollen ankles and tiredness can occur. Occasionally there can be feelings of abdominal fullness and swelling of the stomach.
If you experience any of the above symptoms you should inform your healthcare professional.
What tests will I need?
Most people with tricuspid regurgitation will have an ECG and an echocardiogram.
What are the treatment options available?
Most people with tricuspid regurgitation will not require any treatment, just regular monitoring..
If you are symptomatic then you might be prescribed a medication known as a water tablets (furosemide or bumetanide).
It is very rare to consider intervention (either keyhole or surgical) on the tricuspid valve, if this is the only leaking heart valve you have. But If you are undergoing surgery on your mitral valve, and your tricuspid valve is also leaking, then the surgeon will usually also fix the tricuspid valve in a repair operation.
Technologies are evolving all the time and there are some emerging devices which may be able to treat severe tricuspid regurgitation via a keyhole approach. However, this technology has not been proven yet in scientific trials and is not available on a widespread level in the UK.
Do I need to change my lifestyle?
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As with any type of heart disease, it is important that you follow a healthy diet, keep your weight within a normal range and do not smoke. Most patients with tricuspid regurgitation will be encouraged to take regular gentle exercise but you should check this with your doctor. If you are planning pregnancy, you should discuss this with your doctor first and let them know immediately if you become pregnant.
Patients with tricuspid regurgitation are also advised to take good care of their teeth and skin to prevent the risk of heart valve infection (endocarditis), which is a rare but serious condition.
Teeth
It is important to take good care of your teeth by brushing twice a day and visiting your dentist for regular check-ups (at least once per year). If you have toothache or an abscess it is really important that you get treated for this quickly. Be sure to tell your dentist you have a heart condition.
Skin
Keep your skin clean by washing regularly. Wash any cuts and grazes and keep them clean until they heal. See your GP if your skin becomes red or inflamed. Avoid cosmetic procedures (e.g. tattoos, body piercing, fillers etc) that involve breaking the skin.