Heart valve disorders
Tricuspid valve regurgitation
What is tricuspid valve regurgitation?
First, a little information about your tricuspid valve and what it does:
Your tricuspid valve lies between your right atrium and your right ventricle. It has three leaflets, or cusps, as its name suggests.
The valve opens to allow de-oxygenated (used) blood from your body to flow from your atrium into your ventricle, and it closes again as your ventricle contracts to push the blood into your pulmonary artery and on into your lungs to be re-oxygenated.
The closing of your tricuspid valve prevents blood from flowing back into your right atrium when your right ventricle contracts.
Tricuspid valve regurgitation
For more information about what happens when your heart beats, take a look at How your heart pumps.
If you have tricuspid valve regurgitation, that means that your tricuspid valve is leaking, and some of the blood in your right ventricle is being pushed back into your right atrium again when your ventricle contracts.
Very mild, or trace, tricuspid regurgitation is extremely common and causes no symptoms or ongoing health problems.
However, moderate or severe tricuspid valve regurgitation can increase the pressure in your right ventricle, which then often enlarges and weakens over time, worsening your regurgitation and leading to right heart failure.
Any kind of damage to the tricuspid valve can cause you to develop a leaky valve and tricuspid valve regurgitation. The damage might be the result of infection, trauma, or a valve defect that has been present since birth. However, disorders that result in an enlarged right ventricle are the most common cause.
If your condition is severe you may need to have surgery to repair or replace your tricuspid valve.
Tricuspid valve regurgitation is also known as tricuspid regurgitation or tricuspid insufficiency.
What causes tricuspid valve regurgitation?
Most commonly, tricuspid valve regurgitation develops when your right ventricle becomes enlarged. This can happen if you have a lung problem, such as emphysema, or any other disorder that increases the blood pressure in your right ventricle. When your ventricle enlarges, it can distort the shape of your tricuspid valve and prevent it from closing properly.
Causes of right ventricle enlargement, which can lead to tricuspid valve regurgitation, include:
- Lung diseases like emphysema or chronic obstructive pulmonary disease (COPD)
- Pulmonary hypertension: High blood pressure in your lungs
- Left heart failure
- Cardiomyopathy: An enlarged or weakened heart muscle
- Severe left-side (mitral or aortic) heart valve disorders
The most common direct cause of tricuspid valve damage is endocarditis. The tricuspid is the valve most often affected by endocarditis acquired as a result of IV drug abuse.
Rheumatic heart disease (which is now rare in the developed world) can damage your tricuspid valve and, if it does, it’s likely that your mitral and aortic valves are also damaged.
And finally, damage can be caused by trauma or injury, or a congenital disorder – something you were born with.
Causes of tricuspid valve damage that can result in regurgitation include:
- Endocarditis: An infection of the heart’s chambers and valves
- Rheumatic heart disease
- Injury or trauma
- A congenital heart defect
What are the symptoms of tricuspid valve regurgitation?
If you have trace, or mild, tricuspid valve regurgitation you will probably have no symptoms at all.
If your condition worsens, the first noticeable symptoms may be those of the underlying condition that’s causing your regurgitation (pulmonary hypertension, for example, or cardiomyopathy).
Usually, your first symptom will be that common indicator of right-heart problems, swollen legs and feet.
Here are some common symptoms of severe tricuspid valve regurgitation. If you experience these symptoms you should immediately seek medical advice:
- Swollen legs, feet, and ankles
- Shortness of breath
- Decreased capacity for exercise
How is tricuspid valve regurgitation treated?
Your doctor will determine the best course of treatment for your tricuspid valve regurgitation based on the underlying cause and on the severity of your symptoms.
If you have mild or trace regurgitation you probably won’t need any treatment at all.
However, if your tricuspid valve regurgitation is being caused by an infection or a lung disorder, your doctor will want to treat that condition. Once the underlying disorder is controlled, it may not be necessary, additionally, to treat your regurgitation itself.
If your tricuspid valve regurgitation does need treatment, options include:
- Diuretics to reduce your fluid load and limit swelling if heart failure is developing
- Surgery: In severe cases, you may need surgery to repair or replace your tricuspid valve
What are the aims of treatment?
The first aim of treatment for people with tricuspid valve regurgitation is to cure or manage any underlying cause.
The aim of treating the tricuspid valve regurgitation itself is to stabilize or improve your symptoms and prevent them from worsening.
In cases of severe disease, you will require surgery, and the aim is to restore normal valve function.