Materiały źródłowe

• #1 Tricuspid Valve Disease: Causes, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17578-tricuspid-valve-disease

  Tricuspid valve disease is a condition that occurs when the valve between the two right heart chambers doesn’t function properly. […] To diagnose tricuspid valve disease, a healthcare provider will conduct a physical exam, which will involve: […] If they suspect that you have a heart condition, they may refer you to a cardiologist or order some tests: […] Based on your test results and symptoms, your healthcare provider will recommend a treatment plan. […] Advanced or severe cases may require tricuspid valve surgery to repair or replace the valve. […] The outlook with tricuspid valve disease is generally good. Many people manage with regular follow-up appointments and medications. When needed, surgical repair or replacement usually corrects the condition. […] If you’re experiencing signs like general fatigue, weakness, swelling or fluttering, talk to your primary care provider or a cardiologist. They may recommend monitoring the condition, medication to manage symptoms or surgery to repair or replace the valve.

• #1 Tricuspid valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tricuspid-valve-regurgitation/diagnosis-treatment/drc-20350173

  Tricuspid valve regurgitation can occur silently. It may be found when imaging tests of the heart are done for other reasons. […] To diagnose tricuspid valve regurgitation, a healthcare professional examines you and asks questions about your symptoms and medical history. The care professional listens to your heart using a device called a stethoscope. A whooshing sound called a heart murmur may be heard. […] To learn if you have tricuspid valve regurgitation, tests are done to check your heart and heart valves. The tests can show how severe any valve disease is and help learn the cause. […] An echocardiogram is done Echocardiogram. An echocardiogram uses sound waves to create pictures of the heart in motion. The test can show the structure of the heart and heart valves and how blood flows through the heart.

• #1 Tricuspid Valve Disease | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/tricuspid-valve-disease/1000

  When listening to your heart, your doctor may hear a heart murmur as the first sign of tricuspid valve disease. This characteristic whooshing sound is turbulent blood flowing through the valve. […] To confirm the diagnosis, your doctor orders an echocardiogram. This test uses ultrasound waves to produce a video of the heart pumping and valves opening and closing. The ultrasound probe may be placed on your chest (transthoracic) or guided down your throat (transesophageal) for a better view. Find out more about cardiovascular diagnostics, including echocardiography.

• #1 Tricuspid regurgitation: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000169.htm

  The health care provider may find abnormalities when gently pressing with the hand (palpating) on your chest. The provider may also feel a pulse over your liver. The physical exam may show liver and spleen swelling. […] Listening to the heart with a stethoscope may reveal a murmur or other abnormal sounds. There may be signs of fluid buildup in the abdomen. […] An electrocardiogram (ECG) or echocardiogram may show enlargement of the right side of the heart. Doppler echocardiography or right-sided cardiac catheterization may be used to measure blood pressure inside the heart and lungs. […] Other tests, such as CT scan or MRI of the chest (heart), may reveal enlargement of the right side of the heart and other changes.

• #1 Tricuspid Valve Regurgitation | Diagnosis | UK Healthcare

  https://ukhealthcare.uky.edu/gill-heart-vascular-institute/conditions/structural-heart-disease/tricuspid-valve-regurgitation/diagnosis

  Tricuspid valve regurgitation often has no symptoms, and its commonly diagnosed while imaging studies are being done for other conditions. However, if your healthcare provider believes you have tricuspid valve regurgitation, they may perform a physical exam and cardiovascular imaging studies. […] Your doctor may conduct a physical exam to begin diagnosing a suspected case of tricuspid valve regurgitation. During this exam, the doctor may press their hand on your chest to feel for palpitations. They may also notice pulsation of your liver, as well as swelling of your liver or your spleen. In addition, your doctor will listen to your heart using a stethoscope. Unusual sounds, such as a murmur, are clues that your ventricle may not be functioning correctly. […] After your physical exam, your doctor may further investigate by ordering an echocardiogram (ECG or echo). This type of test records activity of the heart using high-frequency sound waves, or ultrasound. A technologist called a sonographer conducts this test by applying gel to your chest that makes it easier for sound waves to reach your heart. The sonographer will then move a transducer across your chest to send sound waves to your heart. The echo created by those waves is translated into images of your heart as it beats.

• #1 Tricuspid valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tricuspid-valve-disease/diagnosis-treatment/drc-20573710

  To diagnose tricuspid valve disease, a healthcare professional examines you and listens to your heart and lungs. Tests are done to check heart health. Tricuspid valve disease may be found when tests are done for another reason. […] Some types of tricuspid valve disease may be hard to diagnose. You may be sent to a doctor trained in heart diseases, called a cardiologist. […] Tests to diagnose tricuspid valve disease may include: […] After testing confirms a diagnosis of tricuspid valve disease, your healthcare team may tell you the stage of disease. Staging helps determine the most appropriate treatment. […] If a healthcare professional thinks you might have tricuspid valve disease, you are usually sent to a doctor trained in heart diseases. This type of doctor is called a cardiologist.

• #1 Tricuspid valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tricuspid-valve-regurgitation/diagnosis-treatment/drc-20350173

  Tests to diagnose tricuspid valve regurgitation may include: Echocardiogram. This is the main test for diagnosing tricuspid valve regurgitation. It uses sound waves to create pictures of the beating heart. It shows how blood flows through the heart and the heart valves, including the tricuspid valve. […] There are different types of echocardiograms. A standard echocardiogram is called a transthoracic echocardiogram (TTE). It creates pictures of the heart from outside the body. Sometimes, a more-detailed echocardiogram is needed to better see the tricuspid valve. This test is called a transesophageal echocardiogram (TEE). It creates pictures of the heart from inside the body. The type of echocardiogram you have depends on the reason for the test and your overall health. […] Electrocardiogram (ECG or EKG). This quick test records the electrical signals in the heart. It shows how the heart is beating.

• #1 Tricuspid Valve Regurgitation: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21627-tricuspid-valve-regurgitation

  Tricuspid valve regurgitation is when the valve between your right atrium and right ventricle doesnt fully close. This causes some blood to flow the wrong way. […] Treatment includes medications and surgery. […] Your healthcare provider will perform a physical exam and order tests as needed to diagnose this condition. […] Healthcare providers typically use echocardiography to diagnose tricuspid regurgitation. This test can also identify any valve abnormalities that would indicate the primary form of the condition. […] Your provider will tailor a treatment plan to your needs, including the severity of the regurgitation and its causes.

• #1 Diagnosis and treatment of tricuspid valve disease: current and future perspectives – PubMed

  https://pubmed.ncbi.nlm.nih.gov/27048553/

  The assessment and management of tricuspid valve disease have evolved substantially during the past several years. […] Non-invasive assessment of tricuspid regurgitation must define its cause and severity; advanced three-dimensional echocardiography, MRI, and CT are gaining in clinical application. […] The indications for tricuspid valve surgery to treat tricuspid regurgitation are related to the cause of the disorder, the context in which it is encountered, its severity, and its effects on right ventricular function. […] However, many patients with unoperated severe tricuspid regurgitation are also deemed at very high or prohibitive surgical risk. […] Novel transcatheter therapies have begun to emerge for the treatment of tricuspid regurgitation in such patients. Experience with such therapies is preliminary and further studies are needed to determine their role in the management of this disorder.

• #1 Tricuspid Regurgitation – Diagnosis

  https://www.my-connext.com/valvular-diseases/tricuspid/diagnosis?spec=12&cHash=f0c0c3522f1c9af901467c2cbd4b46ef

  Echocardiography is the key technique used to confirm the diagnosis of VHD, as well as to assess its aetiology, mechanisms, function, severity, and prognosis. Echocardiography is typically used in assessing both the mechanism and severity of TR. […] TransThoracic Echocardiography (TTE) can distinguish between primary and secondary TR, identify comorbid LSHD, and estimate pulmonary artery systolic pressure. In the presence of TR, tricuspid valve analysis is mandatory; two-dimensional (2D)-TTE imaging is the technique of choice. […] TransoEsophageal Echocardiography (TEE) is advised in case of suboptimal TTE images. Distinction between primary and secondary TR is warranted. TEE can also be used during transcatheter procedures, to guide the device into the correct position. […] Colour flow imaging can identify small regurgitant jets (jets of backward flowing blood), and can be used to diagnose TR, however it is not recommended to assess TR severity.

• #1 Tricuspid valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tricuspid-valve-regurgitation/diagnosis-treatment/drc-20350173

  Chest X-ray. A chest X-ray shows the condition of the heart and lungs. […] Cardiac MRI. This test uses magnetic fields and radio waves to create detailed pictures of the heart. Cardiac MRI may help show the severity of tricuspid valve regurgitation. The test also gives details about the lower right heart chamber. […] Cardiac catheterization. This test isn’t often used to diagnose tricuspid valve disease. But it can be helpful if other tests haven’t diagnosed the cause of the condition. […] After testing confirms a diagnosis of tricuspid or other heart valve disease, your healthcare team may tell you the stage of disease. Staging helps determine the most appropriate treatment. […] The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs.

• #1 Tricuspid Regurgitation – Diagnosis

  https://www.my-connext.com/valvular-diseases/tricuspid/diagnosis?spec=12&cHash=f0c0c3522f1c9af901467c2cbd4b46ef

  CT can provide a detailed image of the valve anatomy, especially of the systolic and diastolic ventricle geometry. This information is key for pre-procedural planning of a catheter-based intervention. […] CMR imaging is typically used as a test for evaluating RV function. Although CMR assessment of TR is feasible, it is less established than for other valves. Patients with inadequate echocardiography may receive CMR imaging to assess the severity of valvular lesions, ventricular volume, or systolic function, thus CMR can aid the evaluation of TR severity. […] An interactive tool for in-hospital mortality prediction. It is a simple, accurate and dedicated risk-score model to predict outcome after isolated tricuspid valve surgery for severe tricuspid regurgitation at an individual level according to the pre-operative clinical, biological and echocardiographic presentation.

• #1 Tricuspid Valve Regurgitation Diagnosis | Temple Health

  https://www.templehealth.org/services/conditions/tricuspid-valve-regurgitation/diagnosis

  When diagnosing tricuspid valve regurgitation, your doctor will perform a physical exam to assess your pulse and if theres evidence of a heart murmur. Your doctor will also review your medical history and may order any of the following diagnostic tests: […] Echocardiogram is a non-invasive test using ultrasound (sound waves) and a device called a transducerwhich is placed on the surface of the chestto create a moving picture of the heart. It shows the valve opening width and valve shape after closing, as well as the size and shape of the heart chambers and problems with pumping function. […] Holter monitor is used to give a detailed analysis of the hearts electrical activity over a period of 24 hours (1 day). For this non-invasive test, which is done at home, 4 or 5 adhesive electrodes are placed on the chest and connected to an electrical recording device that is usually worn on the belt or on a neck/shoulder strap. This device records every heartbeat for the duration of the time that its worn.

• #1 Tricuspid valve disease – Harris- Annals of Cardiothoracic Surgery

  https://www.annalscts.com/article/view/15056/15210

  The most common test to diagnose tricuspid valve disease is an echocardiogram, which provides detailed ultrasound imaging of the heart. […] Other tests that may be carried out include an electrocardiogram, whereby electrodes assess the hearts electrical activity, and stress tests, which assess the response of the heart to physical exertion, either by electrocardiography or echocardiography.

• #1 Tricuspid valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tricuspid-valve-regurgitation/diagnosis-treatment/drc-20350173

  Heart valve disease is staged into four basic groups: Stage A: At risk. Risk factors for heart valve disease are present. […] Stage B: Progressive. Valve disease is mild or moderate. There are no heart valve symptoms. […] Stage C: Asymptomatic severe. There are no heart valve symptoms, but the valve disease is severe. […] Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms.

• #1 Tricuspid valve regurgitation: no longer the “forgotten valve”

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-16/Tricuspid-valve-regurgitation-no-longer-the-forgotten-valve

  Tricuspid regurgitation (TR) is a highly prevalent valvular heart disease. […] In the diagnosis for TR, an accurate evaluation of the complex tricuspid anatomy and remodelling of the right ventricle is pivotal. […] A comprehensive understanding of the tricuspid valve morphology, its anatomical variability and the interaction of all its functional components with the valve apparatus (tricuspid annulus, leaflets, chordae tendineae and papillary muscles, RV and atrium) is essential to establish and fine-tune the diagnosis of TR. […] In daily clinical practice, two-dimensional (2D) transthoracic echocardiography remains the cornerstone in establishing the diagnosis of TR and grading its severity by providing qualitative, semi-quantitative and quantitative parameters. […] By combining the aforementioned parameters, current guidelines advocate a multiparametric approach to improve the diagnostic accuracy of severe TR.

• #1 Heart valve disease module 4: diagnosis – The British Journal of Cardiology

  https://bjcardio.co.uk/2016/03/heart-valve-disease-module-4-diagnosis-2/7/

  The minimum echocardiographic dataset for the tricuspid valve consists of: a detailed description of the appearance and motion of the valve, colour map width, diastolic V max, mean gradient and pressure half-time if there is stenosis, tricuspid annulus diameter, RV size and systolic function, pulmonary artery pressure, presence of left-sided disease. […] Tricuspid regurgitation is graded by the width of the vena contracta of the systolic colour signal in multiple views. A width 7 mm is indicative of severe regurgitation although there are no well validated cut-offs for differentiating mild from moderate tricuspid regurgitation. […] In severe regurgitation, the signal is intense and triangular in shape. The jet is a useful means for assessing the tricuspid regurgitation (TR) severity. […] Where possible, a pulsed wave (PW) Doppler trace should be obtained within the hepatic vein, looking for systolic flow reversal (80% sensitivity for severe TR).

• #1 Heart valve disease module 4: diagnosis – The British Journal of Cardiology

  https://bjcardio.co.uk/2016/03/heart-valve-disease-module-4-diagnosis-2/7/

  In severe tricuspid stenosis, the leaflets will be calcified or restricted and demonstrate limited mobility, and a valve area 1cm2 by the continuity equation. […] CT is not useful. The stenosed tricuspid valve may appear thickened, calcified or shortened. […] In tricuspid stenosis (TS), turbulent flow may be seen across the tricuspid valve with in-plane SSFP imaging. Although it is technically feasible to measure the peak velocity across the tricuspid valve, this is not often used in clinical practice. […] Tricuspid regurgitation may be seen as a black signal void with cine imaging. Regurgitant volumes and fraction can be calculated by measuring the forward stroke volume in the main pulmonary artery and subtracting this from the RV stroke volume on SSFP imaging, although this is not used clinically.

• #1 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Intraprocedural monitoring: TEE is the imaging modality of choice for the guidance of transcatheter interventions, including tricuspid transcatheter edge-to-edge repair (T-TEER), annular repair, and orthotopic valve replacement. Intracardiac echocardiography (ICE) is a potential alternative to TEE. Hybrid or fusion imaging, involving the overlay of fluoroscopy and TEE or CT images, also can be used for transcatheter procedural planning and guidance. […] Post-procedural evaluation: Surveillance with transthoracic echocardiography (TTE) after a surgical or transcatheter intervention typically is performed before discharge; 1 month, 6 months, and 1 year after intervention, and then yearly. Structural abnormalities including thrombosis, endocarditis, and calcification or degenerative changes can be assessed using TEE or gated CT.

• #1 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811/The-diagnosis-and-treatment-of-tricuspid-regurgitation

  Severe TR is a serious multifactorial disease which, if left untreated, leads to progressive right heart failure and is associated with a poor prognosis. To prevent irreversible damage to the right heart and the development of secondary organ complications, early outpatient diagnosis with timely referral to an experienced heart valve center is crucial.

• #1 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points […] The following are key points to remember from a state-of-the-art paper on tricuspid regurgitation (TR): from imaging to clinical trials to resolving the unmet need for treatment. […] Background: TR is prevalent and associated with high mortality but underdiagnosed and profoundly undertreated by surgery. Challenges in intervention for TR include poor outcomes and TR recurrence after surgical intervention, and persistent or recurrent TR and residual right ventricular (RV) consequences after transcatheter repair. This review addresses TR diagnosis, quantification, multimodality imaging, and management. […] TR etiologies and mechanisms: TR etiologies include organic (caused by leaflet perforation or cleft, leaflet flail or papillary muscle rupture, or restricted leaflet motion associated with rheumatic or carcinoid disease), iatrogenic (caused by leaflet perforation or restriction after cardiac implanted electronic device [CIED] lead insertion, or leaflet tear or chordal rupture after ablation or CIED lead insertion), or functional (associated with atrial fibrillation, pulmonary hypertension [PH], or RV dysfunction).

• #1 Tricuspid Valve Disease (Types, Causes, Symptoms and Treatment)

  https://patient.info/doctor/tricuspid-valve-disease

  Tricuspid regurgitation should be assessed first by echocardiography. In primary tricuspid regurgitation, specific abnormalities of the valve can be identified. In secondary tricuspid regurgitation, annular dilatation, along with right ventricular and right atrium dimensions, as well as right ventricular function should be measured in view of their prognostic relevance. Estimation of pulmonary pressures using Doppler gradient may be impossible or might underestimate the severity of pulmonary hypertension in the presence of severe tricuspid regurgitation, justifying cardiac catheterisation to evaluate pulmonary vascular resistances.

• #1 Tricuspid Valve Disease (Types, Causes, Symptoms and Treatment)

  https://patient.info/doctor/tricuspid-valve-disease

  The majority of serious heart valve problems affect the mitral and aortic valves. Tricuspid regurgitation (TR) is more common than tricuspid stenosis and usually develops in association with pulmonary hypertension in patients with mitral stenosis or mitral regurgitation. […] Detection requires careful evaluation, as it is almost always associated with left-sided valve lesions that dominate the presentation. Clinical signs are often masked by associated valve lesions, especially mitral stenosis. […] Echocardiography: to detect and quantify tricuspid stenosis and for assessment of the dimensions of cardiac chambers, determination of right ventricular and pulmonary pressures and detection of associated other heart valve abnormalities. […] Echocardiography provides the most useful information. Tricuspid stenosis is often overlooked and requires careful evaluation. Echocardiographic evaluation of valve anatomy and subvalvular apparatus is important to assess valve reparability.

• #1 Tricuspid regurgitation – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/472

  The disease has largely been undertreated and its impact is under appreciated. […] Key diagnostic factors include fatigue and effort intolerance, dyspnea, palpitations, jugular venous abnormality, irregular heart rhythm, parasternal systolic murmur, increased systolic murmur on inspiration (Carvallo sign), and peripheral edema. […] 1st tests to order include transthoracic or transesophageal echocardiogram, ECG, LFTs, serum BUN and creatinine, CBC, and CXR. […] Tests to consider include operative transesophageal echocardiogram, postoperative transthoracic echocardiogram, cardiac catheterization, and cardiac MRI (preferred technique for evaluation of right ventricular size and function).

• #1 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811/The-diagnosis-and-treatment-of-tricuspid-regurgitation

  Background: It is estimated that 6% of persons over age 75 have clinically relevant tricuspid regurgitation (TR). This condition carries a high mortality and is of particular interest because of the recent development of new interventional treatments. […] In the outpatient setting, timely diagnosis by transthoracic echocardiography is crucial. […] Although the relevance of TR is undisputed, the disease is still frequently diagnosed too late, and diagnosis is followed by specific treatment in far fewer than 10% of cases. Early diagnosis and evaluation of treatment options would be indicated in order to prevent manifest heart failure, despite the lack, to date, of evidence from randomized controlled trials to back up this recommendation. […] Diagnosis of clinically significant TR should prompt more detailed exploration at a heart valve center. The tricuspid valve pathology has to be evaluated, the underlying causes of TR have to be identified, and the cardiac and extracardiac implications have to be delineated. The multimodal diagnostic investigations conducted to this end form an essential basis for the subsequent treatment recommendations.

• #1 Tricuspid Regurgitation – Diagnosis

  https://www.my-connext.com/valvular-diseases/tricuspid/diagnosis?spec=12&cHash=f0c0c3522f1c9af901467c2cbd4b46ef

  Tricuspid Regurgitation (TR) is a complex disease that has multiple causes, and is associated with high rates of morbidity and mortality. TR is highly prevalent, and among valve diseases, is one of the most undertreated. If left untreated, TR initiates a cascade of events that can lead to right-sided Heart Failure (HF) and death. […] Most early-stage TR is clinically silent, and even with severe TR, some patients may be asymptomatic. In patients who become symptomatic of TR, the prevalence and severity of the symptoms are greater in patients with more severe TR. […] TR can cause or aggravate the signs and symptoms of HF, and symptomatic patients with TR commonly present with the symptoms of HF, and not the TR itself. […] VHD may be detected incidentally during patient examinations, such as the presence of heart murmur during a physical examination, or heart valve abnormalities on chest imaging or non-invasive testing (i.e. echocardiography).

• #1 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Current and developing interventions: Tricuspid annuloplasty is the standard of care for surgical intervention. Valve replacement might be preferable in patients with severe RV dilation and distorted subvalvular apparatus. T-TEER is the dominant transcatheter intervention for TR. Evolving options for transcatheter intervention include incorporation of a spacer in the T-TEER device, leaflet extensions, subvalvular manipulations, and new devices. […] Clinical trials and endpoints: Because of heterogenous outcomes associated with intervention, clinical staging and scoring systems should integrate TR severity, heart failure severity, and comorbidities. The TRI-SCORE was developed to predict operative mortality for TV surgery, and incorporates clinical data, biomarkers, and echocardiographic parameters. Early feasibility studies are pivotal in investigating emerging therapies for TR. Five clinical trials in the United States and Europe currently are investigating intervention for TR: CLASP II (T-TEER), TRILUMINATE Pivotal Trial (T-TEER), TRISCEND II Pivotal Trial (transcatheter valve replacement), TRI-FR (T-TEER), and TRIC-I-HF (transcatheter annuloplasty and T-TEER).

• #1 About Heart Valve Disease | Heart Disease | CDC

  https://www.cdc.gov/heart-disease/about/heart-valve-disease.html

  Heart valve disease is when any valve in the heart has damage or is diseased. […] The tricuspid valve allows blood to flow from the right atrium to the right ventricle. […] Early diagnosis, treatment, and routine monitoring of heart valve disease are critical to helping patients live healthy lives. […] Screenings such as stethoscope checks, echocardiograms, and timely referrals to cardiologists can help ensure that heart valve disease does not go unmanaged. […] Effective treatment options are available for heart valve disease, including noninvasive options. It is important to discuss the options that are best and what follow-up care may be recommended for each patient. […] As with any heart condition, continued care and regular screenings to monitor disease progression are needed for people who are living with heart valve disease.

• #1 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Future directions: The complexity of the TV and the heterogeneity of TR pose challenges to care. Awareness of the importance of TR and its assessment and management are important, including referral of patients to tertiary heart valve centers. The authors advocate for a change in the paradigm of TR management; with consideration for early and multimodality imaging-based selective treatment to reduce the risks of irreversible RV damage, organ failure, and residual heart failure.

• #2 Tricuspid valve regurgitation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tricuspid-valve-regurgitation/diagnosis-treatment/drc-20350173

  Tricuspid valve regurgitation can occur silently. It may be found when imaging tests of the heart are done for other reasons. […] To diagnose tricuspid valve regurgitation, a healthcare professional examines you and asks questions about your symptoms and medical history. The care professional listens to your heart using a device called a stethoscope. A whooshing sound called a heart murmur may be heard. […] To learn if you have tricuspid valve regurgitation, tests are done to check your heart and heart valves. The tests can show how severe any valve disease is and help learn the cause. […] An echocardiogram is done Echocardiogram. An echocardiogram uses sound waves to create pictures of the heart in motion. The test can show the structure of the heart and heart valves and how blood flows through the heart.

• #2 Tricuspid Valve Disease | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/tricuspid-valve-disease

  When listening to your heart, your doctor may hear a heart murmur as the first sign of tricuspid valve disease. This characteristic whooshing sound is turbulent blood flowing through the valve. […] To confirm the diagnosis, your doctor orders an echocardiogram. This test uses ultrasound waves to produce a video of the heart pumping and valves opening and closing. The ultrasound probe may be placed on your chest (transthoracic) or guided down your throat (transesophageal) for a better view.

• #2 Tricuspid Valve Regurgitation | Diagnosis | UK Healthcare

  https://ukhealthcare.uky.edu/gill-heart-vascular-institute/conditions/structural-heart-disease/tricuspid-valve-regurgitation/diagnosis

  Tricuspid valve regurgitation often has no symptoms, and its commonly diagnosed while imaging studies are being done for other conditions. However, if your healthcare provider believes you have tricuspid valve regurgitation, they may perform a physical exam and cardiovascular imaging studies. […] Your doctor may conduct a physical exam to begin diagnosing a suspected case of tricuspid valve regurgitation. During this exam, the doctor may press their hand on your chest to feel for palpitations. They may also notice pulsation of your liver, as well as swelling of your liver or your spleen. In addition, your doctor will listen to your heart using a stethoscope. Unusual sounds, such as a murmur, are clues that your ventricle may not be functioning correctly. […] After your physical exam, your doctor may further investigate by ordering an echocardiogram (ECG or echo). This type of test records activity of the heart using high-frequency sound waves, or ultrasound. A technologist called a sonographer conducts this test by applying gel to your chest that makes it easier for sound waves to reach your heart. The sonographer will then move a transducer across your chest to send sound waves to your heart. The echo created by those waves is translated into images of your heart as it beats.

• #2 Tricuspid regurgitation – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/472

  The disease has largely been undertreated and its impact is under appreciated. […] Key diagnostic factors include fatigue and effort intolerance, dyspnea, palpitations, jugular venous abnormality, irregular heart rhythm, parasternal systolic murmur, increased systolic murmur on inspiration (Carvallo sign), and peripheral edema. […] 1st tests to order include transthoracic or transesophageal echocardiogram, ECG, LFTs, serum BUN and creatinine, CBC, and CXR. […] Tests to consider include operative transesophageal echocardiogram, postoperative transthoracic echocardiogram, cardiac catheterization, and cardiac MRI (preferred technique for evaluation of right ventricular size and function).

• #2 Tricuspid Valve Disease: Causes, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17578-tricuspid-valve-disease

  Tricuspid valve disease is a condition that occurs when the valve between the two right heart chambers doesn’t function properly. […] To diagnose tricuspid valve disease, a healthcare provider will conduct a physical exam, which will involve: […] If they suspect that you have a heart condition, they may refer you to a cardiologist or order some tests: […] Based on your test results and symptoms, your healthcare provider will recommend a treatment plan. […] Advanced or severe cases may require tricuspid valve surgery to repair or replace the valve. […] The outlook with tricuspid valve disease is generally good. Many people manage with regular follow-up appointments and medications. When needed, surgical repair or replacement usually corrects the condition. […] If you’re experiencing signs like general fatigue, weakness, swelling or fluttering, talk to your primary care provider or a cardiologist. They may recommend monitoring the condition, medication to manage symptoms or surgery to repair or replace the valve.

• #2 Tricuspid valve disease – Harris- Annals of Cardiothoracic Surgery

  https://www.annalscts.com/article/view/15056/15210

  The most common test to diagnose tricuspid valve disease is an echocardiogram, which provides detailed ultrasound imaging of the heart. […] Other tests that may be carried out include an electrocardiogram, whereby electrodes assess the hearts electrical activity, and stress tests, which assess the response of the heart to physical exertion, either by electrocardiography or echocardiography.

• #2 Tricuspid valve disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5494422/

  The most common test to diagnose tricuspid valve disease is an echocardiogram, which provides detailed ultrasound imaging of the heart. The sound device or transducer may be placed on the chest wall, known as a transthoracic echocardiogram, or a tube and transducer are inserted into the esophagus for more detailed imaging, known as a transesophageal echocardiogram. These tests evaluate the structure and function of both the heart muscle and valves. […] Other tests that may be carried out include an electrocardiogram, whereby electrodes assess the hearts electrical activity, and stress tests, which assess the response of the heart to physical exertion, either by electrocardiography or echocardiography.

• #2 Mitral and tricuspid valve disease: diagnosis and management. Consensus document of the Section on Valvular Heart Disease and the Cardiovascular Imaging, Clinical Cardiology, and Interventional Cardiology Associations of the Spanish Societ

  https://www.revespcardiol.org/en-mitral-tricuspid-valve-disease-diagnosis-articulo-S1885585722002067

  The diagnosis and management of mitral and tricuspid valve disease have undergone major changes in the last few years. […] The emergence of transcatheter therapies for aortic and mitral valve disease triggered increasing interest in their use in TR and an exponential growth in studies investigating transcatheter approaches for a supposedly benign disease that has classically been undertreated. […] Echocardiography remains the first-line imaging modality for the diagnosis and management of TR. […] Cardiac magnetic resonance imaging (MRI) serves as a diagnostic alternative when sufficient anatomic definition of the tricuspid valve is not possible with TEE. […] TR severity should be assessed using multiple qualitative, semiquantitative, and quantitative variables. […] Multimodality imaging is essential for adequate TR assessment, especially in the context of transcatheter therapies.

• #2 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Diagnostic imaging for tricuspid valve (TV) structure and TR severity: Echocardiographic assessment should include TV morphologic assessment and TR causes and mechanism; three-dimensional (3D) echocardiography can be especially useful. TR assessment should be quantitative, with severe TR defined by effective regurgitant orifice area 0.40 cm2. Cardiac magnetic resonance (CMR) imaging can assess TR severity and RV function. Computed tomography (CT) can be complementary to transesophageal echocardiography (TEE) for the assessment of TV leaflet anatomy and TR mechanism, and for anatomical measurements associated with intervention. Cardiac catheterization can be useful in the assessment of PH. […] Diagnostic imaging for RV function and cardiac remodeling: RV function and remodeling can be assessed with RV ejection fraction (RVEF) or RV end-systolic volume index (RVESVi) assessed by 3D echocardiography, CMR, or CT; echocardiographic tricuspid annular plane excursion (TAPSE), and RV-pulmonary artery (PA) coupling (measured echocardiographically as the ratio of TAPSE to PA systolic pressure).

• #2 Testing for Heart Valve Problems | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/getting-an-accurate-heart-valve-diagnosis/testing-for-heart-valve-problems

  An echocardiogram looks at your heart’s structure and checks how well your heart functions. […] A leaking or regurgitating valve can also affect the pressure in both the heart chambers as well as surrounding blood vessels. […] The valve gradient can be used to determine the severity of the valve disorder. […] A chest X-ray shows the location, size and shape of the heart, lungs and blood vessels. This can provide clues to a valve problem that include an enlarged or thickened heart and calcium deposits on the aorta or pericardium. […] A CT scan creates images of the valve anatomy and allows for evaluation of the severity of stenosis and regurgitation. […] Cardiac catheterization can provide important information about narrowed heart valves, leaky heart valves or blood that is not flowing through the heart as it should. […] CMR has become an optimal technique in assessing people with heart valve disease without the need for radiation. Its enhanced diagnostic power can determine the type and severity of valve disease.

• #2 Tricuspid Valve Stenosis Diagnosis | Temple Health

  https://www.templehealth.org/services/conditions/tricuspid-valve-stenosis/diagnosis

  Holter monitor is used to give a detailed analysis of the hearts electrical activity over a period of 24 hours (1 day). For this non-invasive test, which is done at home, 4 or 5 adhesive electrodes are placed on the chest and connected to an electrical recording device that is usually worn on the belt or on a neck/shoulder strap. This device records every heartbeat for the duration of the time that its worn. […] Other possible tests may include: exercise stress test, special cardiac Doppler studies, and radionuclide scans.

• #2 Tricuspid Valve Disease (Types, Causes, Symptoms and Treatment)

  https://patient.info/doctor/tricuspid-valve-disease

  Tricuspid regurgitation should be assessed first by echocardiography. In primary tricuspid regurgitation, specific abnormalities of the valve can be identified. In secondary tricuspid regurgitation, annular dilatation, along with right ventricular and right atrium dimensions, as well as right ventricular function should be measured in view of their prognostic relevance. Estimation of pulmonary pressures using Doppler gradient may be impossible or might underestimate the severity of pulmonary hypertension in the presence of severe tricuspid regurgitation, justifying cardiac catheterisation to evaluate pulmonary vascular resistances.

• #2 Tricuspid valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tricuspid-valve-disease/diagnosis-treatment/drc-20573710

  To diagnose tricuspid valve disease, a healthcare professional examines you and listens to your heart and lungs. Tests are done to check heart health. Tricuspid valve disease may be found when tests are done for another reason. […] Some types of tricuspid valve disease may be hard to diagnose. You may be sent to a doctor trained in heart diseases, called a cardiologist. […] Tests to diagnose tricuspid valve disease may include: […] After testing confirms a diagnosis of tricuspid valve disease, your healthcare team may tell you the stage of disease. Staging helps determine the most appropriate treatment. […] If a healthcare professional thinks you might have tricuspid valve disease, you are usually sent to a doctor trained in heart diseases. This type of doctor is called a cardiologist.

• #2 Heart valve disease module 4: diagnosis – The British Journal of Cardiology

  https://bjcardio.co.uk/2016/03/heart-valve-disease-module-4-diagnosis-2/7/

  The minimum echocardiographic dataset for the tricuspid valve consists of: a detailed description of the appearance and motion of the valve, colour map width, diastolic V max, mean gradient and pressure half-time if there is stenosis, tricuspid annulus diameter, RV size and systolic function, pulmonary artery pressure, presence of left-sided disease. […] Tricuspid regurgitation is graded by the width of the vena contracta of the systolic colour signal in multiple views. A width 7 mm is indicative of severe regurgitation although there are no well validated cut-offs for differentiating mild from moderate tricuspid regurgitation. […] In severe regurgitation, the signal is intense and triangular in shape. The jet is a useful means for assessing the tricuspid regurgitation (TR) severity. […] Where possible, a pulsed wave (PW) Doppler trace should be obtained within the hepatic vein, looking for systolic flow reversal (80% sensitivity for severe TR).

• #2 Tricuspid Regurgitation – Cardiovascular Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/cardiovascular-disorders/valvular-disorders/tricuspid-regurgitation

  Tricuspid regurgitation (TR) is insufficiency of the tricuspid valve causing blood flow from the right ventricle to the right atrium during systole. […] Diagnosis is by physical examination and echocardiography. […] More moderate or severe TR may be suggested by history and physical examination. Confirmation is by echocardiography. […] Severe TR is characterized echocardiographically by 1 of the following: 2-Dimensional failure of coaptation or flail, Dense, triangular, early peaking, continuous wave Doppler of TR jet, Large flow convergence zone proximal to the valve, Large regurgitant jet on color Doppler (50% of right atrial area), Systolic flow reversal in the hepatic veins (specific for severe TR), Vena contracta width 7 mm. […] When TR is moderate or severe, the peak regurgitant velocity will underestimate pulmonary pressure.

• #2 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811/The-diagnosis-and-treatment-of-tricuspid-regurgitation

  Background: It is estimated that 6% of persons over age 75 have clinically relevant tricuspid regurgitation (TR). This condition carries a high mortality and is of particular interest because of the recent development of new interventional treatments. […] In the outpatient setting, timely diagnosis by transthoracic echocardiography is crucial. […] Although the relevance of TR is undisputed, the disease is still frequently diagnosed too late, and diagnosis is followed by specific treatment in far fewer than 10% of cases. Early diagnosis and evaluation of treatment options would be indicated in order to prevent manifest heart failure, despite the lack, to date, of evidence from randomized controlled trials to back up this recommendation. […] Diagnosis of clinically significant TR should prompt more detailed exploration at a heart valve center. The tricuspid valve pathology has to be evaluated, the underlying causes of TR have to be identified, and the cardiac and extracardiac implications have to be delineated. The multimodal diagnostic investigations conducted to this end form an essential basis for the subsequent treatment recommendations.

• #2 New Mitral & Tricuspid Center Offers Advanced Diagnosis and Treatment for Valve Diseases | News | Advances in Cardiology & Heart Surgery | NewYork-Presbyterian

  https://www.nyp.org/advances/article/cardiology/new-mitral-and-tricuspid-center-offers-advanced-diagnosis-and-treatment-for-valve-diseases

  Patients may have severe or even massive tricuspid regurgitation, but not really be overtly symptomatic. […] This is why it is crucial to have a team of experts in heart valve conditions, including echocardiographers such as Dr. Hahn and surgeons like Dr. George and Dr. Geirsson, taking care of these patients. […] The care team performs a thorough workup that includes advanced cardiac imaging and a review of the patients medical history to match them with the treatment plan that is likely to be most effective. […] Treatments may include: […] Transcatheter tricuspid valve repair and replacement. […] Dr. Kodali, Dr. Hahn, and their colleagues have been leaders in clinical trials that have advanced tricuspid valve care, including the pivotal TRISCEND II trial that led to the FDA approval in February 2024 of the first transcatheter therapy for the treatment of tricuspid regurgitation.

• #2 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/351301-overview

  Tricuspid regurgitation may result from structural alterations of any or all of the components of the tricuspid valve apparatus. The lesion may be classified as primary when it is caused by an intrinsic abnormality of the valve apparatus or as secondary when it is caused by right ventricular (RV) dilatation or other conditions. […] Color flow Doppler echocardiography is a mainstay for evaluating tricuspid regurgitation. Depending on the etiology and severity of tricuspid regurgitation, treatment may involve medication or surgical repair or replacement of the valve. […] The pathophysiology of tricuspid regurgitation focuses on the structural incompetence of the valve. The incompetence can result from primary structural abnormalities of the leaflets and chordae or, more often, be secondary to myocardial dysfunction and dilatation.

• #2 Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/02/14/18/tricuspid-regurgitation-from

  Tricuspid Regurgitation Diagnosis, Imaging, and Management: Key Points […] The following are key points to remember from a state-of-the-art paper on tricuspid regurgitation (TR): from imaging to clinical trials to resolving the unmet need for treatment. […] Background: TR is prevalent and associated with high mortality but underdiagnosed and profoundly undertreated by surgery. Challenges in intervention for TR include poor outcomes and TR recurrence after surgical intervention, and persistent or recurrent TR and residual right ventricular (RV) consequences after transcatheter repair. This review addresses TR diagnosis, quantification, multimodality imaging, and management. […] TR etiologies and mechanisms: TR etiologies include organic (caused by leaflet perforation or cleft, leaflet flail or papillary muscle rupture, or restricted leaflet motion associated with rheumatic or carcinoid disease), iatrogenic (caused by leaflet perforation or restriction after cardiac implanted electronic device [CIED] lead insertion, or leaflet tear or chordal rupture after ablation or CIED lead insertion), or functional (associated with atrial fibrillation, pulmonary hypertension [PH], or RV dysfunction).

• #2 Tricuspid Valve Disease (Types, Causes, Symptoms and Treatment)

  https://patient.info/doctor/tricuspid-valve-disease

  The majority of serious heart valve problems affect the mitral and aortic valves. Tricuspid regurgitation (TR) is more common than tricuspid stenosis and usually develops in association with pulmonary hypertension in patients with mitral stenosis or mitral regurgitation. […] Detection requires careful evaluation, as it is almost always associated with left-sided valve lesions that dominate the presentation. Clinical signs are often masked by associated valve lesions, especially mitral stenosis. […] Echocardiography: to detect and quantify tricuspid stenosis and for assessment of the dimensions of cardiac chambers, determination of right ventricular and pulmonary pressures and detection of associated other heart valve abnormalities. […] Echocardiography provides the most useful information. Tricuspid stenosis is often overlooked and requires careful evaluation. Echocardiographic evaluation of valve anatomy and subvalvular apparatus is important to assess valve reparability.

• #2 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811/The-diagnosis-and-treatment-of-tricuspid-regurgitation

  Detailed transthoracic and transesophageal echocardiography is required for thorough evaluation of TR. […] The severity of TR is assessed by means of multiparametric measurements (qualitative, quantitative, and semiquantitative). […] If significant and symptomatic TR persists despite optimal treatment of underlying conditions and medical therapy, one should weigh up whether specific tricuspid valve treatment is indicated. […] The currently prevailing guidelines recommend tricuspid valve surgery, with simultaneous operative treatment of the left heart in the presence of severe TR or dilatation of the tricuspid annulus in patients with low surgical risk. […] Numerous interventional treatment procedures have been developed on the basis of surgical techniques in recent years. These procedures are divided into interventions to restore leaflet coaptation (essentially edge-to-edge repair by means of clipping), annuloplasties, and direct (orthotopic) or indirect (heterotopic) transcatheter tricuspid valve replacement.

• #2 The Diagnosis and Treatment of Tricuspid Regurgitation (23.08.2024)

  https://di.aerzteblatt.de/int/archive/article/240811/The-diagnosis-and-treatment-of-tricuspid-regurgitation

  Severe TR is a serious multifactorial disease which, if left untreated, leads to progressive right heart failure and is associated with a poor prognosis. To prevent irreversible damage to the right heart and the development of secondary organ complications, early outpatient diagnosis with timely referral to an experienced heart valve center is crucial.

• #3 Tricuspid Valve Disease | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/tricuspid-valve-disease

  When listening to your heart, your doctor may hear a heart murmur as the first sign of tricuspid valve disease. This characteristic whooshing sound is turbulent blood flowing through the valve. […] To confirm the diagnosis, your doctor orders an echocardiogram. This test uses ultrasound waves to produce a video of the heart pumping and valves opening and closing. The ultrasound probe may be placed on your chest (transthoracic) or guided down your throat (transesophageal) for a better view.

• #3 Tricuspid Regurgitation – Cardiovascular Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/cardiovascular-disorders/valvular-disorders/tricuspid-regurgitation

  Cardiac MRI is the preferred method for evaluating RV size and function. […] ECG is usually normal but, in advanced cases, may show tall peaked P waves caused by right atrial enlargement, a tall R or QR wave in V1 characteristic of RV hypertrophy, or atrial fibrillation. […] Cardiac catheterization is indicated for accurate measurement of pulmonary pressure when TR is severe and to evaluate coronary anatomy when surgery is planned. […] Timing of intervention for tricuspid regurgitation depends on the patient’s symptoms and RV function. […] Severe LV dysfunction or severe pulmonary hypertension may make the surgical risk prohibitive. […] Tricuspid valve repair is generally preferred to replacement. […] Tricuspid valve replacement is indicated when TR is due to carcinoid syndrome or Ebstein anomaly. […] Progress is being made toward a percutaneous valve repair procedure. Early studies have shown improvement in the degree of regurgitation and in right-sided hemodynamics.

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