Tricuspid regurgitation (TR) is a type of heart valve disease that affects the tricuspid valve, one of the four valves in the heart. This valve is located between the right atrium and right ventricle, and its main job is to ensure that blood flows in the correct direction — from the atrium to the ventricle — without leaking backward. In tricuspid regurgitation, the valve does not close properly, allowing blood to flow back into the right atrium when the right ventricle contracts. Over time, this backflow increases pressure and volume in the right side of the heart, which can eventually lead to right-sided heart failure if left untreated.
The condition can be functional (secondary) or organic (primary). Functional TR is the most common form and usually develops as a result of another heart problem, such as pulmonary hypertension, left-sided heart failure, or mitral valve disease, which cause dilation of the right heart chambers. In contrast, organic TR is due to direct structural abnormalities of the tricuspid valve itself — for instance, rheumatic heart disease, infective endocarditis, congenital malformations, or trauma.
Symptoms of tricuspid regurgitation often appear gradually and may include fatigue, swelling of the legs, abdomen, or neck veins (edema and ascites), shortness of breath, and palpitations. Because these symptoms are similar to those seen in other cardiac conditions, TR can easily go unnoticed until it becomes severe.
Diagnosis typically begins with a physical examination, during which a doctor may detect a heart murmur. The gold-standard diagnostic test is echocardiography (echo), which uses sound waves to create detailed images of the heart’s structure and function. Additional tests, such as electrocardiograms (ECG), chest X-rays, or cardiac MRI, may also be used to assess the severity and underlying cause.
Treatment depends on the cause and severity of the regurgitation. In mild cases, managing the underlying condition — such as controlling pulmonary hypertension or treating left-sided heart disease — may be enough. Medications like diuretics can help relieve symptoms related to fluid retention. However, in more severe or progressive cases, surgical intervention may be necessary. This can involve tricuspid valve repair, which preserves the patient’s native valve, or tricuspid valve replacement using a mechanical or biological prosthesis.
Early detection and treatment are key to preventing complications and improving quality of life. With timely medical care, many patients can manage tricuspid regurgitation effectively and maintain good heart function.
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