Tricuspid Valve Disease
Treating Cardiovascular Diseases in Wisconsin and Northern Illinois
The tricuspid valve is located on the right side of the heart, between the upper and lower chambers. Its job is to make sure blood flows in a forward direction from the top right chamber, or atrium, to the lower right chamber, or ventricle. A healthy tricuspid valve remains tightly closed when the ventricle contracts, allowing blood to flow out of the ventricle and into the lungs.
Tricuspid valve disease symptoms can stem from three types of tricuspid valve disease:
- Tricuspid atresia is a congenital condition (present at birth) that occurs when tissue blocks the normal flow of blood between the two chambers on the right side of the heart. It is a life-threatening condition that needs to be treated with surgery. Tricuspid atresia can be associated with other congenital heart defects.
- Tricuspid regurgitation occurs when the tricuspid valve doesn’t close tightly. This allows some blood to leak back into the atrium when the ventricle contracts.
- Tricuspid stenosis occurs when the valve’s flaps, or leaflets, become stiff and narrow, restricting blood flow into the ventricle. This causes the right atrium to enlarge and prevents the right ventricle from getting enough blood.
Tricuspid Valve Disease Symptoms
Tricuspid valve disease may be tolerated for a long time without symptoms. When symptoms occur, they are dependent on the severity of the disease and how quickly the condition developed. Most often, the disease develops gradually, allowing the heart to adapt to the changes. When tricuspid valve disease symptoms occur, they may include:
- A heart murmur, or abnormal blood flow through your valve
- A sensation of an irregular or rapid heart beat
- Fatigue or weakness
- Nausea or vomiting
- Shortness of breath with activity
- Swelling of the ankles, feet and abdomen
Causes of Tricuspid Valve Disease
There are many possible causes of tricuspid valve regurgitation:
- A diet medication known as “Fen-Phen”
- Autoimmune diseases, such as rheumatoid arthritis or lupus
- Carcinoid tumors, which release a hormone that can damage the valve
- Congenital defects, such as Ebstein’s anomaly
- Increased pressure through the tricuspid valve, caused by pulmonary hypertension (high pressure in the lungs)
- Infective endocarditis
- Injury or trauma to the chest that causes the papillary muscle or chordae (cords that hold the valve leaflets in place) to break
- Marfan syndrome, a connective tissue disorder
- Pacemaker or defibrillator wires that may interfere with the proper closing of the valve
- Radiation therapy
- Rheumatic fever, a complication of an untreated strep throat infection
- Swelling or dilating of the right ventricle, which can stem from a variety of conditions
- Valve disease on the left side of the heart, such as mitral regurgitation and mitral stenosis
The most common cause of tricuspid stenosis is rheumatic fever. Rheumatic fever has become less common in the United States as more people receive antibiotics to treat strep infections. If tricuspid valve stenosis is caused by rheumatic fever, it is often associated with mitral and/or aortic valve disease.
Diagnosing Tricuspid Valve Disease
Tricuspid valve disease is typically diagnosed during a physical exam when a health care provider listens to your heart with a stethoscope. Palpating, or pressing on your abdomen, may reveal a pulse over your liver or enlargement of your liver, which can indicate heart failure.
Cardiac testing may include:
- Cardiac catheterization
- Chest X-ray
- Electrocardiogram testing or EKG
- Magnetic resonance imaging
- Ultrasound testing, including echocardiography testing or transesophageal testing TEE
Treating Tricuspid Valve Disease
Treatment depends on the severity of the condition and any underlying causes. If there are no or very few symptoms, treatment may not be necessary. However, your doctor is likely to recommend periodic monitoring with physical exams and diagnostic testing.
- Medications cannot cure or correct the structural problem with the tricuspid valve. However, they may be prescribed to treat the symptoms. For example, diuretics can help remove excess fluid to manage swelling. Antiarrhythmicdrugs canhelp control an irregular heart rhythm.
- Valve surgery to repair the tricuspid valve is recommended when regurgitation or stenosis becomes severe. Valve repair is preferred over valve replacement because it allows the individual to keep their native valve, which lowers the risk of infection, decreases the need for life-long use of blood-thinning medications and may prevent the need for future valve intervention.
- Valve replacement may be performed when valve repair isn’t an option. Replacement valves can be mechanical or biological. Mechanical valves are man-made and can last a lifetime. However, people with mechanical valves are required to take blood-thinning medications for the rest of their lives. Mechanical valves are rarely used to replace the tricuspid valve because the lower pressure on the right side of the heart increases the likelihood of blood clots forming on the valve. Biological valves are taken from cows or pigs, or made from human tissue.
Setting New Standards in Treating Heart Valve Disease
Aurora Health Care has extensive expertise in evaluating and treating patients with valvular heart disease, the second most common type of heart disease after coronary artery disease.
In 2011, The Valvular Heart Disease Center opened at Aurora St. Luke’s Medical Center in Milwaukee, Wisconsin to help diagnose and treat valve disorders and plan appropriate medical and surgical treatments. Advanced imaging technology placed in the hands of experts ensures that the most accurate diagnosis is made. Our multidisciplinary team of specialists offers treatment options that help our patients thrive for a lifetime.
Aurora doctors are conveniently located throughout eastern Wisconsin and northeastern Illinois. Find a doctor or heart specialist near you. To get a second opinion or if you need assistance finding a provider, please call 888-649-6892.