Tricuspid valve disease

Overview

Tricuspid valve disease refers to a condition affecting the valve that separates the right atrium and right ventricle of the heart. The valve can be affected in several ways, such as leaking (known as regurgitation), becoming rigid or narrow (stenosis), or being malformed since birth (atresia). This leads to an increased workload on the heart in order to pump blood to both the lungs and the rest of the body.

The tricuspid valve is an important component of the four heart valves that help regulate the proper flow of blood in the heart. Its function is to ensure the steady and rhythmic pumping of blood between the right upper heart chamber (atrium) and the right lower heart chamber (ventricle). If the tricuspid valve fails to function properly, it can result in a condition known as tricuspid valve disease.

Tricuspid valve disease can manifest in several types, which include:

• Tricuspid valve regurgitation: The backflow of blood from the lower right chamber into the right atrium, due to the improper closure of the tricuspid valve, results in an increased amount of blood in the atrium. This can lead to the enlargement of the atrium and alterations in the pressure of both the heart and blood vessels, which may cause damage to the heart.
• Tricuspid valve stenosis: Tricuspid stenosis is a condition where the tricuspid valve opening is narrow or rigid, restricting blood flow between the two chambers. This can cause enlargement of the right atrium, which can affect blood flow and pressure. Consequently, the amount of blood that circulates through the lungs and the rest of the body may decrease due to tricuspid stenosis.
• Tricuspid atresia: This congenital heart defect is characterized by the absence of the tricuspid valve, leading to a blockage of blood flow between the right heart chambers due to the presence of a solid sheet of tissue.
• Ebstein anomaly: This is a rare congenital heart defect in which the tricuspid valve is improperly positioned and its flaps are abnormally shaped. As a result, there is a possibility of blood flowing back through the valve, which is known as tricuspid valve regurgitation.

Tricuspid valve disease can occur in conjunction with other cardiac valve disorders, such as abnormalities in the mitral or aortic valves. The symptoms and treatments may vary depending on the specific valve issue. However, tricuspid valve disease can lead to symptoms and heart damage over time. Treatment options may include regular monitoring, medication, and surgery.

Symptoms

While minor tricuspid valve disease may not cause any symptoms or complications, moderate to severe cases can lead to the expansion of the heart and potentially irreversible damage over time. People with this condition may experience various symptoms, such as:

• Constant tiredness or weakness
• Irregular heart rhythm, or arrhythmia
• Inflammation or swelling in the legs, ankles, feet or abdomen
• Increased liver size
• Fluttering or pounding sensation in the chest or neck
• Heart murmur
• Pulsing or fluttering feeling in the chest or neck.
• Breathing difficulties or dyspnea
• Skin that is unusually chilly

Causes

Tricuspid valve disease can be caused by various factors, which may include:

• Congenital heart defect: Certain condition such as Ebstein’s abnormality can cause tricuspid valve disease. Ebstein’s abnormality is a very rare birth condition. It affects the heart’s tricuspid valve, causing an enlarged heart, irregular heartbeats, and heart failure.
• Autoimmune disorders: Diseases that affect the immune system can lead to tricuspid valve disease, such as lupus, Marfan syndrome or rheumatoid arthritis.
• Injury: Trauma due to medical emergencies, diagnostic and treatment procedures, such as damage from heart attack, pacemaker, or myocardial biopsy can cause tricuspid valve disease.
• Medications and treatment: Medicines, particularly diet drug commonly known as fen-phen, or fenfluramine and phentermine can cause tricuspid valve disease. People who had cancer treatments such as radiation or tumor therapy to the chest can also acquire this disease.

Other causes include infection, such as rheumatic fever or endocarditis, enlarged right ventricle, and pulmonary hypertension.