Materiały źródłowe

• #1 Tricuspid Regurgitation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526121/

  Tricuspid regurgitation is a condition characterized by the backward flow of blood from the right ventricle into the right atrium during systole due to an incompetent tricuspid valve. This regurgitation often results from structural abnormalities of the valve apparatus, including issues with the valve leaflets, annulus, or papillary muscles. Contributing factors may include valve degeneration, annular dilation, or damage from conditions such as pulmonary hypertension or infective endocarditis. […] In tricuspid regurgitation, lesions fall into 2 categories: primary, where intrinsic abnormalities in the tricuspid valvular apparatus are responsible, and secondary, where right atrial or ventricular dilatation causes tricuspid regurgitation. The most common cause of tricuspid regurgitation is secondary or functional regurgitation. Secondary disorders like tricuspid annular dilation and leaflet tethering in right ventricular pressure and volume overload are largely responsible for tricuspid regurgitation compared to primary disorders involving the valve apparatus.

• #2 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 general, the aetiology of TR is classified according to the presence of primary tricuspid valve pathology (primary TR), the presence of associated left-sided heart disease (secondary TR) or the presence of atrial fibrillation without any associated left-sided heart disease (isolated TR). […] Whereas reported estimated frequencies of primary TR are 8-10%, secondary TR constitutes the predominant mechanism in 90% and, more frequently, isolated TR is now being recognised as a distinct entity. […] Primary TR is caused by an abnormality of the tricuspid valve and/or its subvalvular apparatus (tricuspid leaflets, chordae, papillary muscles, or annulus), due to congenital or acquired causes. […] Acquired causes of primary TR include tumours (carcinoid disease, myxoma), drug-induced leaflet damage (ergot alkaloids, dopamine agonists, anorectic drugs), iatrogenic injury (transvenous pacing or defibrillator leads, endomyocardial biopsy), endocarditis, systemic diseases (lupus erythematosus, sarcoidosis), radiation, rheumatic disease, and trauma.

• #3 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 general, the aetiology of TR is classified according to the presence of primary tricuspid valve pathology (primary TR), the presence of associated left-sided heart disease (secondary TR) or the presence of atrial fibrillation without any associated left-sided heart disease (isolated TR). […] Whereas reported estimated frequencies of primary TR are 8-10%, secondary TR constitutes the predominant mechanism in 90% and, more frequently, isolated TR is now being recognised as a distinct entity. […] Primary TR is caused by an abnormality of the tricuspid valve and/or its subvalvular apparatus (tricuspid leaflets, chordae, papillary muscles, or annulus), due to congenital or acquired causes. […] Acquired causes of primary TR include tumours (carcinoid disease, myxoma), drug-induced leaflet damage (ergot alkaloids, dopamine agonists, anorectic drugs), iatrogenic injury (transvenous pacing or defibrillator leads, endomyocardial biopsy), endocarditis, systemic diseases (lupus erythematosus, sarcoidosis), radiation, rheumatic disease, and trauma.

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

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

  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. […] TR can be divided into primary and secondary: Primary TR is relatively rare. It is caused by a lesion of the tricuspid valve due to congenital or acquired disease processes that affect the leaflets or chordal structures, or both. […] Secondary TR is more common and is secondary to other diseases such as left-side heart diseases, pulmonary hypertension, right ventricle dilation, and dysfunction from any cause, without any intrinsic lesion of the tricuspid valve. […] Aetiology is secondary in over 90% of cases, due to pressure and/or volume overload right ventricular dilatation or enlarged right atrium and tricuspid annulus due to chronic atrial fibrillation.

• #5 Tricuspid valve regurgitation | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/tricuspid-valve-regurgitation?content_id=CON-20120486

  Rheumatic fever. This complication of strep throat can cause permanent damage to the heart and heart valves. When that happens, it’s called rheumatic heart valve disease. […] Infection of the lining of the heart and heart valves, also called infective endocarditis. This condition can damage the tricuspid valve. IV drug misuse increases the risk of infective endocarditis. […] Chest injury. An injury to the chest, such as from a car accident, may cause damage that leads to tricuspid valve regurgitation. […] Radiation therapy. Rarely, radiation therapy for cancer that is focused on the chest area can cause tricuspid valve regurgitation.

• #6 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/158484-overview

  Endocarditis is an important cause of tricuspid regurgitation. Factors that can contribute to infection of the valve include alcoholism, intravenous drug use, neoplasms, infected indwelling catheters, extensive burns, and immune deficiency. […] Ebstein anomaly is a congenital malformation of the tricuspid valve characterized by apical displacement of the annular insertion of the septal and posterior leaflets and atrialization of a portion of the ventricular myocardium. […] The incidence of tricuspid valve prolapse (floppy tricuspid valve) varies from 0.3-3.2%. […] Pure tricuspid regurgitation can occur as part of the carcinoid heart syndrome. […] Papillary muscle dysfunction may result from necrosis secondary to myocardial infarction, fibrosis, or infiltrative processes. […] Trauma to the RV may damage the structures of the tricuspid valve, resulting in insufficiency of the structure.

• #7 Tricuspid valve regurgitation | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/tricuspid-valve-regurgitation?content_id=CON-20120486

  In tricuspid valve regurgitation, the valve between the two right heart chambers doesn’t close properly. […] Some people are born with heart valve disease that leads to tricuspid regurgitation. This is called congenital heart valve disease. But tricuspid valve regurgitation also may occur later in life due to infections and other health conditions. […] Causes of tricuspid valve regurgitation include: A heart problem you’re born with, also called a congenital heart defect. Some congenital heart defects affect the shape of the tricuspid valve and how it works. Tricuspid valve regurgitation in children is usually caused by a rare heart problem present at birth called Ebstein anomaly. In this condition, the tricuspid valve does not form correctly. It also is lower than usual in the lower right heart chamber.

• #8 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/158484-overview

  Endocarditis is an important cause of tricuspid regurgitation. Factors that can contribute to infection of the valve include alcoholism, intravenous drug use, neoplasms, infected indwelling catheters, extensive burns, and immune deficiency. […] Ebstein anomaly is a congenital malformation of the tricuspid valve characterized by apical displacement of the annular insertion of the septal and posterior leaflets and atrialization of a portion of the ventricular myocardium. […] The incidence of tricuspid valve prolapse (floppy tricuspid valve) varies from 0.3-3.2%. […] Pure tricuspid regurgitation can occur as part of the carcinoid heart syndrome. […] Papillary muscle dysfunction may result from necrosis secondary to myocardial infarction, fibrosis, or infiltrative processes. […] Trauma to the RV may damage the structures of the tricuspid valve, resulting in insufficiency of the structure.

• #9 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/158484-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 (eg, left ventricular [LV] dysfunction). […] Pure tricuspid regurgitation can be caused by at least 10 conditions, as follows: Rheumatic heart disease, Endocarditis, Ebstein anomaly, Tricuspid valve prolapse, Carcinoid, Papillary muscle dysfunction, Trauma, Connective-tissue diseases, Medications, RV dilatation. […] Tricuspid regurgitation secondary to rheumatic involvement is usually associated with mitral and aortic valve pathology. The valve develops diffuse fibrous thickening without commissural fusion, fused chordae, or calcific deposits.

• #10 Tricuspid valve regurgitation | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/tricuspid-valve-regurgitation?content_id=CON-20120486

  Rheumatic fever. This complication of strep throat can cause permanent damage to the heart and heart valves. When that happens, it’s called rheumatic heart valve disease. […] Infection of the lining of the heart and heart valves, also called infective endocarditis. This condition can damage the tricuspid valve. IV drug misuse increases the risk of infective endocarditis. […] Chest injury. An injury to the chest, such as from a car accident, may cause damage that leads to tricuspid valve regurgitation. […] Radiation therapy. Rarely, radiation therapy for cancer that is focused on the chest area can cause tricuspid valve regurgitation.

• #11 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/158484-overview

  Endocarditis is an important cause of tricuspid regurgitation. Factors that can contribute to infection of the valve include alcoholism, intravenous drug use, neoplasms, infected indwelling catheters, extensive burns, and immune deficiency. […] Ebstein anomaly is a congenital malformation of the tricuspid valve characterized by apical displacement of the annular insertion of the septal and posterior leaflets and atrialization of a portion of the ventricular myocardium. […] The incidence of tricuspid valve prolapse (floppy tricuspid valve) varies from 0.3-3.2%. […] Pure tricuspid regurgitation can occur as part of the carcinoid heart syndrome. […] Papillary muscle dysfunction may result from necrosis secondary to myocardial infarction, fibrosis, or infiltrative processes. […] Trauma to the RV may damage the structures of the tricuspid valve, resulting in insufficiency of the structure.

• #12

  https://continentalhospitals.com/diseases/tricuspid-valve-regurgitation/

  Carcinoid Syndrome: This rare condition, usually associated with carcinoid tumors in the gastrointestinal tract, can lead to fibrosis of the tricuspid valve leaflets, resulting in regurgitation. […] Idiopathic: In some cases, tricuspid regurgitation may occur without an identifiable cause, termed idiopathic.

• #13 Tricuspid Regurgitation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526121/

  Tricuspid regurgitation is most commonly secondary in adults, with probable normal anatomical leaflets and chords. Dilatation of the right atrium and the right ventricle, along with dilatation of the tricuspid annulus and tethering of the tricuspid valve leaflet, are some of the causes of secondary tricuspid regurgitation. This may result from conditions affecting the right ventricle or may be due to an increase in right ventricle systolic pressure, often with pulmonary hypertension. […] In adolescents and young adults, the cause of tricuspid regurgitation is usually congenital, but conditions that directly affect the tricuspid valvular apparatus are rare in adults. […] Causes of primary TR include the following: Infective endocarditis, Iatrogenic, Traumatic, Rheumatic valve disease, Carcinoid syndrome, Myxomatous degeneration associated with tricuspid valve prolapse, Marantic endocarditis in systemic lupus erythematosus or rheumatoid arthritis, Endomyocardial fibrosis, Drug-induced disease. […] The conditions that induce pulmonary hypertension and secondary right ventricle dilatation include left-sided heart disease, pulmonary hypertension, right atrial abnormalities, stenosis of the pulmonic valve or pulmonary artery, and hyperthyroidism.

• #14 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/158484-overview

  Endocarditis is an important cause of tricuspid regurgitation. Factors that can contribute to infection of the valve include alcoholism, intravenous drug use, neoplasms, infected indwelling catheters, extensive burns, and immune deficiency. […] Ebstein anomaly is a congenital malformation of the tricuspid valve characterized by apical displacement of the annular insertion of the septal and posterior leaflets and atrialization of a portion of the ventricular myocardium. […] The incidence of tricuspid valve prolapse (floppy tricuspid valve) varies from 0.3-3.2%. […] Pure tricuspid regurgitation can occur as part of the carcinoid heart syndrome. […] Papillary muscle dysfunction may result from necrosis secondary to myocardial infarction, fibrosis, or infiltrative processes. […] Trauma to the RV may damage the structures of the tricuspid valve, resulting in insufficiency of the structure.

• #15 Tricuspid valve regurgitation | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/tricuspid-valve-regurgitation?content_id=CON-20120486

  Rheumatic fever. This complication of strep throat can cause permanent damage to the heart and heart valves. When that happens, it’s called rheumatic heart valve disease. […] Infection of the lining of the heart and heart valves, also called infective endocarditis. This condition can damage the tricuspid valve. IV drug misuse increases the risk of infective endocarditis. […] Chest injury. An injury to the chest, such as from a car accident, may cause damage that leads to tricuspid valve regurgitation. […] Radiation therapy. Rarely, radiation therapy for cancer that is focused on the chest area can cause tricuspid valve regurgitation.

• #16

  https://continentalhospitals.com/diseases/tricuspid-valve-regurgitation/

  Infective Endocarditis: Bacterial or fungal infections of the heart valves, known as infective endocarditis, can damage the tricuspid valve leaflets and lead to regurgitation. […] Congenital Heart Defects: Some individuals are born with abnormalities of the tricuspid valve, which can predispose them to regurgitation later in life. These defects may include Ebstein’s anomaly, where the tricuspid valve is abnormally formed and positioned within the heart. […] Rheumatic Fever: Although less common in developed countries, rheumatic fever, a complication of untreated streptococcal infections, can cause inflammation and damage to heart valves, including the tricuspid valve. […] Trauma: Severe chest trauma or blunt force injury to the chest can damage the tricuspid valve or its supporting structures, leading to regurgitation.

• #17 Tricuspid regurgitation: Etiology, clinical features, and evaluation – UpToDate

  https://www.uptodate.com/contents/tricuspid-regurgitation-etiology-clinical-features-and-evaluation

  Tricuspid regurgitation (TR) is a relatively common abnormality. […] Abnormal degrees of TR in adults are largely secondary (ie, related to tricuspid annular dilation and/or leaflet tethering in the setting of right ventricular [RV] pressure and/or volume overload) and much less often due to primary disorders of the valve apparatus. […] Implantable device leads that cross the tricuspid valve may cause acute or chronic TR. The reported frequency of pacemaker lead-associated TR ranges from 7 to 45 percent, can be progressive, and is associated with an increased rate of adverse clinical outcomes.

• #18 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/158484-overview

  Endocarditis is an important cause of tricuspid regurgitation. Factors that can contribute to infection of the valve include alcoholism, intravenous drug use, neoplasms, infected indwelling catheters, extensive burns, and immune deficiency. […] Ebstein anomaly is a congenital malformation of the tricuspid valve characterized by apical displacement of the annular insertion of the septal and posterior leaflets and atrialization of a portion of the ventricular myocardium. […] The incidence of tricuspid valve prolapse (floppy tricuspid valve) varies from 0.3-3.2%. […] Pure tricuspid regurgitation can occur as part of the carcinoid heart syndrome. […] Papillary muscle dysfunction may result from necrosis secondary to myocardial infarction, fibrosis, or infiltrative processes. […] Trauma to the RV may damage the structures of the tricuspid valve, resulting in insufficiency of the structure.

• #19 Tricuspid valve regurgitation | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/tricuspid-valve-regurgitation?content_id=CON-20120486

  Rheumatic fever. This complication of strep throat can cause permanent damage to the heart and heart valves. When that happens, it’s called rheumatic heart valve disease. […] Infection of the lining of the heart and heart valves, also called infective endocarditis. This condition can damage the tricuspid valve. IV drug misuse increases the risk of infective endocarditis. […] Chest injury. An injury to the chest, such as from a car accident, may cause damage that leads to tricuspid valve regurgitation. […] Radiation therapy. Rarely, radiation therapy for cancer that is focused on the chest area can cause tricuspid valve regurgitation.

• #20 Tricuspid valve regurgitation | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/tricuspid-valve-regurgitation

• #21 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/158484-overview

  Marfan syndrome or other connective-tissue diseases (eg, osteogenesis imperfecta, Ehlers-Danlos syndrome) may cause tricuspid regurgitation. […] Medications that act via serotoninergic pathways may cause valvular lesions similar to those observed with carcinoid. […] In persons with an anatomically normal tricuspid valve, a common etiology of tricuspid regurgitation is dilatation of the RV cavity.

• #22 Both mitral and tricuspid regurgitation: Causes and treatment

  https://www.medicalnewstoday.com/articles/both-mitral-and-tricuspid-regurgitation

  In TR, blood leaks backward from the bottom right chamber of the heart, called the right ventricle, into the top right chamber, the right atrium. […] Abnormalities in the tricuspid valve are the cause of primary TR. In secondary TR, the valve is normal, and dilation of the heart chamber causes the regurgitation. […] An enlarged right ventricle is a common cause of TR. Other causes of TR include: Rheumatoid arthritis (RA): RA causes inflammation, which may damage the heart valves. […] Infective endocarditis: Endocarditis is a condition that causes inflammation in the heart. […] Myxomatous degeneration: This condition affects the valves structure and function. […] Marfan syndrome: This condition affects the body’s connective tissues and can damage the heart valves. […] Phentermine (Fen-Phen) use: Phentermine is an appetite suppressant drug that stimulates the brain and spinal cord. The drug has strong links to valvular heart disease and other heart conditions, including TR.

• #23 Tricuspid Regurgitation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526121/

  Tricuspid regurgitation is most commonly secondary in adults, with probable normal anatomical leaflets and chords. Dilatation of the right atrium and the right ventricle, along with dilatation of the tricuspid annulus and tethering of the tricuspid valve leaflet, are some of the causes of secondary tricuspid regurgitation. This may result from conditions affecting the right ventricle or may be due to an increase in right ventricle systolic pressure, often with pulmonary hypertension. […] In adolescents and young adults, the cause of tricuspid regurgitation is usually congenital, but conditions that directly affect the tricuspid valvular apparatus are rare in adults. […] Causes of primary TR include the following: Infective endocarditis, Iatrogenic, Traumatic, Rheumatic valve disease, Carcinoid syndrome, Myxomatous degeneration associated with tricuspid valve prolapse, Marantic endocarditis in systemic lupus erythematosus or rheumatoid arthritis, Endomyocardial fibrosis, Drug-induced disease. […] The conditions that induce pulmonary hypertension and secondary right ventricle dilatation include left-sided heart disease, pulmonary hypertension, right atrial abnormalities, stenosis of the pulmonic valve or pulmonary artery, and hyperthyroidism.

• #24 Tricuspid Regurgitation – Heart and Blood Vessel Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/heart-valve-disorders/tricuspid-regurgitation

  Tricuspid regurgitation is caused by disorders that enlarge the right ventricle. […] Unlike other heart valve disorders, tricuspid regurgitation usually occurs in a normal valve that has been affected by other heart disorders. The most common cause is when the right ventricle enlarges and resistance to blood flow from the right ventricle to the lungs is increased. Resistance may be increased by severe, long-standing lung disorders, such as emphysema or pulmonary hypertension, disorders involving the left side of the heart such as heart failure, and narrowing of the pulmonary valve (pulmonic stenosis), on rare occasions. […] To compensate, the right ventricle enlarges, stretching the tricuspid valve and causing regurgitation. […] Other, less common causes are infection of the heart valves (infective endocarditis) most often due to intravenous injection of illicit drugs, birth defects of the tricuspid valve, injury, rheumatic fever, and weakness of the mitral valve tissue (myxomatous degeneration).

• #25 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/158484-overview

  Marfan syndrome or other connective-tissue diseases (eg, osteogenesis imperfecta, Ehlers-Danlos syndrome) may cause tricuspid regurgitation. […] Medications that act via serotoninergic pathways may cause valvular lesions similar to those observed with carcinoid. […] In persons with an anatomically normal tricuspid valve, a common etiology of tricuspid regurgitation is dilatation of the RV cavity.

• #26 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 general, the aetiology of TR is classified according to the presence of primary tricuspid valve pathology (primary TR), the presence of associated left-sided heart disease (secondary TR) or the presence of atrial fibrillation without any associated left-sided heart disease (isolated TR). […] Whereas reported estimated frequencies of primary TR are 8-10%, secondary TR constitutes the predominant mechanism in 90% and, more frequently, isolated TR is now being recognised as a distinct entity. […] Primary TR is caused by an abnormality of the tricuspid valve and/or its subvalvular apparatus (tricuspid leaflets, chordae, papillary muscles, or annulus), due to congenital or acquired causes. […] Acquired causes of primary TR include tumours (carcinoid disease, myxoma), drug-induced leaflet damage (ergot alkaloids, dopamine agonists, anorectic drugs), iatrogenic injury (transvenous pacing or defibrillator leads, endomyocardial biopsy), endocarditis, systemic diseases (lupus erythematosus, sarcoidosis), radiation, rheumatic disease, and trauma.

• #27 Tricuspid Regurgitation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526121/

  Tricuspid regurgitation is a condition characterized by the backward flow of blood from the right ventricle into the right atrium during systole due to an incompetent tricuspid valve. This regurgitation often results from structural abnormalities of the valve apparatus, including issues with the valve leaflets, annulus, or papillary muscles. Contributing factors may include valve degeneration, annular dilation, or damage from conditions such as pulmonary hypertension or infective endocarditis. […] In tricuspid regurgitation, lesions fall into 2 categories: primary, where intrinsic abnormalities in the tricuspid valvular apparatus are responsible, and secondary, where right atrial or ventricular dilatation causes tricuspid regurgitation. The most common cause of tricuspid regurgitation is secondary or functional regurgitation. Secondary disorders like tricuspid annular dilation and leaflet tethering in right ventricular pressure and volume overload are largely responsible for tricuspid regurgitation compared to primary disorders involving the valve apparatus.

• #28 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

  In secondary TR, the underlying mechanism is characterised by RV dilation and dysfunction, leading to leaflet tethering, tricuspid annulus dilation and leaflet malcoaptation. […] This is most often caused by significant left-sided valvular and myocardial disease, which leads to increased left-sided pressures, pulmonary hypertension, increased RV afterload and remodelling of the RV. […] Finally, isolated TR is a novel entity most frequently seen in elderly patients with a high prevalence of atrial fibrillation, in the absence of concomitant pulmonary hypertension or co-existing left-sided heart disease.

• #29 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

  In secondary TR, the underlying mechanism is characterised by RV dilation and dysfunction, leading to leaflet tethering, tricuspid annulus dilation and leaflet malcoaptation. […] This is most often caused by significant left-sided valvular and myocardial disease, which leads to increased left-sided pressures, pulmonary hypertension, increased RV afterload and remodelling of the RV. […] Finally, isolated TR is a novel entity most frequently seen in elderly patients with a high prevalence of atrial fibrillation, in the absence of concomitant pulmonary hypertension or co-existing left-sided heart disease.

• #30 Etiology, epidemiology, pathophysiology and management of tricuspid regurgitation: an overview – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34957757/

  Significant tricuspid regurgitation (TR) is a common finding, affecting about one in twenty-five subjects among the elderly and presenting more frequently in women than in men. […] Classically, TR has been distinguished as primary and secondary or functional TR (FTR), with the latter being the most prevalent. FTR is a multifactorial disorder, resulting from maladaptive right ventricular remodeling secondary to pulmonary hypertension or from atrial fibrillation leading to dilation of the right atrium, tricuspid annulus and base of the right ventricle, with pathological TV coaptation. Thus two main types of FTR can be identified: pulmonary hypertension-FTR and idiopathic-FTR, depending on which factor, ventricular or atrial respectively, is the primum movens of the disease. […] Appreciable evidence suggests that significant TR leads to worsening prognosis regardless of the underlying etiology and should be addressed as a separate therapeutic target.

• #31 Tricuspid Regurgitation and Pulmonary Hypertension: What’s the Connection? | myPHteam

  https://www.myphteam.com/resources/tricuspid-regurgitation-and-pulmonary-hypertension

  The tricuspid valve is a heart valve that connects the two chambers of the right side of the heart: the right atrium and right ventricle. Tricuspid regurgitation (TR) occurs when this valve doesnt close properly, which can lead to serious effects on the rest of the body. […] Occasionally, TR occurs because of a congenital (birth) defect or an infection in the tricuspid valve, but it more commonly results from other heart conditions. These include other valve disorders and left-sided heart failure, as well as lung disorders like chronic obstructive pulmonary disease (COPD) and PH. […] Does pulmonary hypertension cause regurgitation? Pulmonary hypertension, an umbrella term describing high blood pressure in the lungs’ arteries, is a major risk factor for developing TR. […] When someone has PH, the right side of the heart works harder to pump blood into the lungs. Severe PH can cause the right ventricle to enlarge, a condition known as hypertrophy. Over time, this enlargement can affect how the tricuspid valve works, leading to regurgitation.

• #32 Etiology, epidemiology, pathophysiology and management of tricuspid regurgitation: an overview – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34957757/

  Significant tricuspid regurgitation (TR) is a common finding, affecting about one in twenty-five subjects among the elderly and presenting more frequently in women than in men. […] Classically, TR has been distinguished as primary and secondary or functional TR (FTR), with the latter being the most prevalent. FTR is a multifactorial disorder, resulting from maladaptive right ventricular remodeling secondary to pulmonary hypertension or from atrial fibrillation leading to dilation of the right atrium, tricuspid annulus and base of the right ventricle, with pathological TV coaptation. Thus two main types of FTR can be identified: pulmonary hypertension-FTR and idiopathic-FTR, depending on which factor, ventricular or atrial respectively, is the primum movens of the disease. […] Appreciable evidence suggests that significant TR leads to worsening prognosis regardless of the underlying etiology and should be addressed as a separate therapeutic target.

• #33 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

  In secondary TR, the underlying mechanism is characterised by RV dilation and dysfunction, leading to leaflet tethering, tricuspid annulus dilation and leaflet malcoaptation. […] This is most often caused by significant left-sided valvular and myocardial disease, which leads to increased left-sided pressures, pulmonary hypertension, increased RV afterload and remodelling of the RV. […] Finally, isolated TR is a novel entity most frequently seen in elderly patients with a high prevalence of atrial fibrillation, in the absence of concomitant pulmonary hypertension or co-existing left-sided heart disease.

• #34 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  Tricuspid regurgitation (TR) is a frequently occurring valvular disease in the elderly population, the aetiology is functional in the vast majority of cases, and this valvular disease has become increasingly recognised as an independent predictor of morbidity and mortality. […] Moderate-to-severe TR is pathological and is caused by annular dilatation and/or leaflet abnormalities. […] Recent epidemiological data indicate that FTR accounts for 90% of all-comers with severe TR, and in total 65% of FTR occurs in the context of pulmonary hypertension. […] The pressure overload due to pulmonary hypertension that may or may not be associated with left-sided heart disease causes RV remodelling and tricuspid annular flattening and dilatation, eventually generating FTR. […] Cardiomyopathies with a dilated and hypokinetic phenotype can also produce per se an analogous remodelling process and eventually FTR.

• #35 What You Should Know About Tricuspid Regurgitation

  https://www.verywellhealth.com/what-you-should-know-about-tricuspid-regurgitation-4062651

  The most common cause of tricuspid regurgitation, by far, is a functional disturbance of the tricuspid valve, where the valve itself is essentially normal but leakage occurs because a heart disorder of some kind distorts the heart. This most commonly happens because the right atrium or the right ventricle become dilated in a way that prevents the tricuspid valve from closing completely. […] Heart problems that commonly cause functional tricuspid regurgitation include: Pulmonary artery hypertension, Heart failure, Mitral stenosis or mitral regurgitation, Pulmonary embolism, Hyperthyroidism. […] Most people with significant tricuspid regurgitation will turn out to have a functional valve disorder produced by one of these conditions. A full cardiac evaluation will be required to identify the nature and severity of the underlying problem, and to determine the best way of treating it.

• #36 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. […] Structural changes to the right side of your heart cause most cases of moderate to severe tricuspid regurgitation. Such changes can occur when theres consistently too much pressure or blood in the right side of your heart. This overworks your right atrium and right ventricle, causing one or both to enlarge. […] Less often, tricuspid regurgitation results from abnormal or damaged valve leaflets. Healthcare providers call this form primary tricuspid regurgitation. It has many possible causes, ranging from medical conditions to trauma. […] Factors that can damage your tricuspid valve leaflets, leading to a leaky valve, include: Carcinoid syndrome, Atrial myxoma, Rheumatic heart disease, Infective endocarditis, Ebsteins anomaly and other congenital abnormalities, Myxomatous degeneration, which means your leaflets become thick and too stretchy and cant fully seal shut, Complications of implanted devices (like pacemakers), Radiation therapy to your chest, Severe traumatic injury to your chest (from a major car crash, for example), Certain medications.

• #37 Tricuspid valve regurgitation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/tricuspid-valve-regurgitation-1?case_id=tricuspid-regurgitation-echocardiography-1&lang=us

  Disorders leading to functional (secondary) tricuspid regurgitation include causes of left-sided heart failure (especially from mitral stenosis or mitral regurgitation), pulmonary hypertension, right ventricular myocardial infarction, left-to-right shunts, Eisenmenger syndrome, pulmonary stenosis, pulmonary regurgitation, and hyperthyroidism.

• #38 Tricuspid regurgitation – Wikipedia

  https://en.wikipedia.org/wiki/Tricuspid_regurgitation

  The causes of TR may be classified as congenital or acquired; another classification divides the causes into primary or secondary. Congenital abnormalities are much less common than acquired. The most common acquired TR is due to right ventricular dilatation. Such dilatation is most often due left heart failure or pulmonary hypertension. Other causes of right ventricular dilatation include right ventricular infarction, inferior myocardial infarction, and cor pulmonale. […] In regards to primary and secondary causes they are: Primary causes include Rheumatic, Myxomatous, Ebstein anomaly, Endomyocardial fibrosis, Endocarditis, and Traumatic (blunt chest injury). Secondary causes include Left ventricular systolic dysfunction, Mitral valve stenosis or regurgitation, Chronic lung disease, Pulmonary thromboembolism, Myocardial disease, Right ventricular ischemia and infarction, Left to right shunt, and Carcinoid heart disease.

• #39 Causes

  https://www.cardiosmart.org/topics/tricuspid-regurgitation/causes

  Problems with the mitral valve or aortic valve […] Injury caused while placing or removing pacemaker wires […] Chest injury from a car accident or other blunt trauma […] Marfan syndrome, a genetic disorder that affects the bodys connective tissue […] Radiation therapy for cancer. […] Primary refers to a leaky valve due to abnormal or damaged valve leaflets. This might be caused by chest trauma or a birth defect. With secondary tricuspid regurgitation, the leaflets or flaps are normal, so any leakage is likely due to another medical condition.

• #40 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  Functional TR without pulmonary hypertension or any other identifiable cause is named by some authors isolated and in total accounts for 10% of all FTR diagnoses. […] The pathophysiology and clinical manifestations of TR are characterised by the consequences of increased RA-RV pressure and volume and decrease in cardiac output. […] Although there are studies attempting to evaluate the natural history and prognostic impact of FTR, their findings have sometimes been contradictory, with large variations in outcomes and debate as to whether TR severity, RV function, the underlying FTR aetiology or a combination are the predictors of poor outcome. […] The most cited article demonstrating the negative prognostic impact of FTR showed that, in a retrospective evaluation of 5,223 patients, mortality increased with increasing severity of TR.

• #41 Causes

  https://www.cardiosmart.org/topics/tricuspid-regurgitation/causes

  The most common cause of a leaky tricuspid valve are structural changes that cause part of the heart to widen. The valve gets stretched and misshapen as a result. […] Conditions such as heart failure or cardiomyopathy (when the heart muscle becomes thickened and stiff) that put added strain on the heart can contribute to the valve being stretched. […] Tricuspid regurgitation can also develop as a result of: Infection, such as rheumatic fever (a complication of strep throat) or endocarditis (infection and inflammation of the lining of the heart and heart valves) […] Congenital heart disease, such as Ebstein anomaly in which the tricuspid valve does not form correctly (this is often the cause in younger people with a leaky valve) […] Pulmonary hypertension (high blood pressure in the lungs, which may be due to Chronic obstructive pulmonary disease, or COPD, lung conditions that can block airways and make it difficult to breathe)

• #42 Tricuspid regurgitation – Wikipedia

  https://en.wikipedia.org/wiki/Tricuspid_regurgitation

  The causes of TR may be classified as congenital or acquired; another classification divides the causes into primary or secondary. Congenital abnormalities are much less common than acquired. The most common acquired TR is due to right ventricular dilatation. Such dilatation is most often due left heart failure or pulmonary hypertension. Other causes of right ventricular dilatation include right ventricular infarction, inferior myocardial infarction, and cor pulmonale. […] In regards to primary and secondary causes they are: Primary causes include Rheumatic, Myxomatous, Ebstein anomaly, Endomyocardial fibrosis, Endocarditis, and Traumatic (blunt chest injury). Secondary causes include Left ventricular systolic dysfunction, Mitral valve stenosis or regurgitation, Chronic lung disease, Pulmonary thromboembolism, Myocardial disease, Right ventricular ischemia and infarction, Left to right shunt, and Carcinoid heart disease.

• #43 Tricuspid Regurgitation and Pulmonary Hypertension: What’s the Connection? | myPHteam

  https://www.myphteam.com/resources/tricuspid-regurgitation-and-pulmonary-hypertension

  The tricuspid valve is a heart valve that connects the two chambers of the right side of the heart: the right atrium and right ventricle. Tricuspid regurgitation (TR) occurs when this valve doesnt close properly, which can lead to serious effects on the rest of the body. […] Occasionally, TR occurs because of a congenital (birth) defect or an infection in the tricuspid valve, but it more commonly results from other heart conditions. These include other valve disorders and left-sided heart failure, as well as lung disorders like chronic obstructive pulmonary disease (COPD) and PH. […] Does pulmonary hypertension cause regurgitation? Pulmonary hypertension, an umbrella term describing high blood pressure in the lungs’ arteries, is a major risk factor for developing TR. […] When someone has PH, the right side of the heart works harder to pump blood into the lungs. Severe PH can cause the right ventricle to enlarge, a condition known as hypertrophy. Over time, this enlargement can affect how the tricuspid valve works, leading to regurgitation.

• #44 Tricuspid Regurgitation and Pulmonary Hypertension: What’s the Connection? | myPHteam

  https://www.myphteam.com/resources/tricuspid-regurgitation-and-pulmonary-hypertension

  Why does pulmonary hypertension cause tricuspid regurgitation? PH and TR are closely linked, with each condition making the other worse. When the right ventricle enlarges, it can affect how the tricuspid valve works. A poorly functioning valve forces the heart to work harder, which can make PH worse. Severe TR is tied to worsening PH and a higher risk of serious complications, including increased death rates. […] TR is classified as either primary or secondary based on its underlying cause. […] Primary, or organic, TR develops when there is direct damage to parts of the valve. Congenital conditions, infections, and trauma caused by the implantation of a pacemaker are all causes of this primary type of tricuspid valvular heart disease. […] Secondary, or functional, TR occurs when there is stretching or dilatation (widening or enlargement) of the part of the valve called the annulus, which is the ring of tissue where the valves leaflets sit. The leaflets are the parts that close together, and when their base becomes distended (stretched or swollen), they no longer close properly.

• #45 Tricuspid Regurgitation and Pulmonary Hypertension: What’s the Connection? | myPHteam

  https://www.myphteam.com/resources/tricuspid-regurgitation-and-pulmonary-hypertension

  Functional TR can develop as a result of PH, as well as from left-sided heart disease, and so the conditions share many risk factors. The severity of secondary TR usually depends on how advanced the underlying PH or left-sided heart disease is. […] Heart conditions that alter blood flow between the heart and lungs and increase pulmonary arterial pressure are potential causes of PH (and therefore TR).

• #46 Tricuspid Regurgitation | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/tricuspid-regurgitation

  Tricuspid regurgitation is most often the result of an underlying heart condition that enlarges the right ventricle. But it also can be caused by birth defects, infections or other conditions that damage the valve. […] Health conditions that can cause tricuspid regurgitation include lung problems, such as chronic obstructive pulmonary disease (COPD) or a clot that has traveled to the lungs (a pulmonary embolism). Heart problems, including a weaker left side of the heart and problems with other valves, can also lead to tricuspid regurgitation. These health issues can strain the heart, enlarge the right ventricle and stretch out the valve, making it leaky. […] Conditions that can lead to tricuspid regurgitation in young people include congenital heart defects, such as Ebstein anomaly, or other congenital conditions, including connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome. […] Other things that can damage the tricuspid valve and cause regurgitation include infections, rheumatoid arthritis, radiation therapy, carcinoid tumors, and a history of using the diet pill fen-phen (fenfluramine and phentermine).

• #47 Causes

  https://www.cardiosmart.org/topics/tricuspid-regurgitation/causes

  The most common cause of a leaky tricuspid valve are structural changes that cause part of the heart to widen. The valve gets stretched and misshapen as a result. […] Conditions such as heart failure or cardiomyopathy (when the heart muscle becomes thickened and stiff) that put added strain on the heart can contribute to the valve being stretched. […] Tricuspid regurgitation can also develop as a result of: Infection, such as rheumatic fever (a complication of strep throat) or endocarditis (infection and inflammation of the lining of the heart and heart valves) […] Congenital heart disease, such as Ebstein anomaly in which the tricuspid valve does not form correctly (this is often the cause in younger people with a leaky valve) […] Pulmonary hypertension (high blood pressure in the lungs, which may be due to Chronic obstructive pulmonary disease, or COPD, lung conditions that can block airways and make it difficult to breathe)

• #48 What You Should Know About Tricuspid Regurgitation

  https://www.verywellhealth.com/what-you-should-know-about-tricuspid-regurgitation-4062651

  The most common cause of tricuspid regurgitation, by far, is a functional disturbance of the tricuspid valve, where the valve itself is essentially normal but leakage occurs because a heart disorder of some kind distorts the heart. This most commonly happens because the right atrium or the right ventricle become dilated in a way that prevents the tricuspid valve from closing completely. […] Heart problems that commonly cause functional tricuspid regurgitation include: Pulmonary artery hypertension, Heart failure, Mitral stenosis or mitral regurgitation, Pulmonary embolism, Hyperthyroidism. […] Most people with significant tricuspid regurgitation will turn out to have a functional valve disorder produced by one of these conditions. A full cardiac evaluation will be required to identify the nature and severity of the underlying problem, and to determine the best way of treating it.

• #49

  https://continentalhospitals.com/diseases/tricuspid-valve-regurgitation/

  Tricuspid valve regurgitation is a condition that affects the functioning of the tricuspid valve in the heart. […] When a person has tricuspid valve regurgitation, it means that there is a leakage of blood back into the right atrium during each heartbeat. […] There are several potential causes for this condition: […] Secondary to Left-Sided Heart Disease: Often, tricuspid regurgitation occurs as a consequence of left-sided heart disease, such as mitral valve disease or aortic valve disease. Increased pressure in the left side of the heart can lead to enlargement of the right ventricle and tricuspid annulus, causing the tricuspid valve to leak. […] Right Ventricular Enlargement: Conditions that cause right ventricular enlargement, such as pulmonary hypertension, pulmonary embolism, or chronic lung diseases like chronic obstructive pulmonary disease (COPD), can lead to tricuspid valve regurgitation. Enlargement of the right ventricle can stretch the valve annulus, preventing proper valve closure.

• #50 Tricuspid Regurgitation and Pulmonary Hypertension: What’s the Connection? | myPHteam

  https://www.myphteam.com/resources/tricuspid-regurgitation-and-pulmonary-hypertension

  Functional TR can develop as a result of PH, as well as from left-sided heart disease, and so the conditions share many risk factors. The severity of secondary TR usually depends on how advanced the underlying PH or left-sided heart disease is. […] Heart conditions that alter blood flow between the heart and lungs and increase pulmonary arterial pressure are potential causes of PH (and therefore TR).

• #51 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

  In secondary TR, the underlying mechanism is characterised by RV dilation and dysfunction, leading to leaflet tethering, tricuspid annulus dilation and leaflet malcoaptation. […] This is most often caused by significant left-sided valvular and myocardial disease, which leads to increased left-sided pressures, pulmonary hypertension, increased RV afterload and remodelling of the RV. […] Finally, isolated TR is a novel entity most frequently seen in elderly patients with a high prevalence of atrial fibrillation, in the absence of concomitant pulmonary hypertension or co-existing left-sided heart disease.

• #52 Tricuspid Regurgitation – Cardiovascular Disorders – Merck Manual Professional Edition

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

  Tricuspid regurgitation may be […] Primary tricuspid regurgitation is less common. It can be due to […] Secondary tricuspid regurgitation is due to leaflet tethering, which is the result of reduced leaflet coaptation caused by annular dilation (typical of right atrial dilation caused by chronic atrial fibrillation) and/or papillary muscle displacement (most commonly as a result of left heart disease causing pulmonary hypertension and leading to RV dilation or geometric distortion). […] Long-standing severe TR may lead to RV dysfunctioninduced heart failure and atrial fibrillation.

• #53 Tricuspid Regurgitation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526121/

  Tricuspid regurgitation is most commonly secondary in adults, with probable normal anatomical leaflets and chords. Dilatation of the right atrium and the right ventricle, along with dilatation of the tricuspid annulus and tethering of the tricuspid valve leaflet, are some of the causes of secondary tricuspid regurgitation. This may result from conditions affecting the right ventricle or may be due to an increase in right ventricle systolic pressure, often with pulmonary hypertension. […] In adolescents and young adults, the cause of tricuspid regurgitation is usually congenital, but conditions that directly affect the tricuspid valvular apparatus are rare in adults. […] Causes of primary TR include the following: Infective endocarditis, Iatrogenic, Traumatic, Rheumatic valve disease, Carcinoid syndrome, Myxomatous degeneration associated with tricuspid valve prolapse, Marantic endocarditis in systemic lupus erythematosus or rheumatoid arthritis, Endomyocardial fibrosis, Drug-induced disease. […] The conditions that induce pulmonary hypertension and secondary right ventricle dilatation include left-sided heart disease, pulmonary hypertension, right atrial abnormalities, stenosis of the pulmonic valve or pulmonary artery, and hyperthyroidism.

• #54 Tricuspid valve regurgitation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/tricuspid-valve-regurgitation-1?case_id=tricuspid-regurgitation-echocardiography-1&lang=us

  Disorders leading to functional (secondary) tricuspid regurgitation include causes of left-sided heart failure (especially from mitral stenosis or mitral regurgitation), pulmonary hypertension, right ventricular myocardial infarction, left-to-right shunts, Eisenmenger syndrome, pulmonary stenosis, pulmonary regurgitation, and hyperthyroidism.

• #55 Tricuspid Regurgitation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526121/

  Tricuspid regurgitation is most commonly secondary in adults, with probable normal anatomical leaflets and chords. Dilatation of the right atrium and the right ventricle, along with dilatation of the tricuspid annulus and tethering of the tricuspid valve leaflet, are some of the causes of secondary tricuspid regurgitation. This may result from conditions affecting the right ventricle or may be due to an increase in right ventricle systolic pressure, often with pulmonary hypertension. […] In adolescents and young adults, the cause of tricuspid regurgitation is usually congenital, but conditions that directly affect the tricuspid valvular apparatus are rare in adults. […] Causes of primary TR include the following: Infective endocarditis, Iatrogenic, Traumatic, Rheumatic valve disease, Carcinoid syndrome, Myxomatous degeneration associated with tricuspid valve prolapse, Marantic endocarditis in systemic lupus erythematosus or rheumatoid arthritis, Endomyocardial fibrosis, Drug-induced disease. […] The conditions that induce pulmonary hypertension and secondary right ventricle dilatation include left-sided heart disease, pulmonary hypertension, right atrial abnormalities, stenosis of the pulmonic valve or pulmonary artery, and hyperthyroidism.

• #56 Tricuspid Regurgitation – Heart and Blood Vessel Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/heart-valve-disorders/tricuspid-regurgitation

  Tricuspid regurgitation is caused by disorders that enlarge the right ventricle. […] Unlike other heart valve disorders, tricuspid regurgitation usually occurs in a normal valve that has been affected by other heart disorders. The most common cause is when the right ventricle enlarges and resistance to blood flow from the right ventricle to the lungs is increased. Resistance may be increased by severe, long-standing lung disorders, such as emphysema or pulmonary hypertension, disorders involving the left side of the heart such as heart failure, and narrowing of the pulmonary valve (pulmonic stenosis), on rare occasions. […] To compensate, the right ventricle enlarges, stretching the tricuspid valve and causing regurgitation. […] Other, less common causes are infection of the heart valves (infective endocarditis) most often due to intravenous injection of illicit drugs, birth defects of the tricuspid valve, injury, rheumatic fever, and weakness of the mitral valve tissue (myxomatous degeneration).

• #57 Tricuspid valve regurgitation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/tricuspid-valve-regurgitation-1?case_id=tricuspid-regurgitation-echocardiography-1&lang=us

  Disorders leading to functional (secondary) tricuspid regurgitation include causes of left-sided heart failure (especially from mitral stenosis or mitral regurgitation), pulmonary hypertension, right ventricular myocardial infarction, left-to-right shunts, Eisenmenger syndrome, pulmonary stenosis, pulmonary regurgitation, and hyperthyroidism.

• #58 Tricuspid regurgitation – Wikipedia

  https://en.wikipedia.org/wiki/Tricuspid_regurgitation

  The causes of TR may be classified as congenital or acquired; another classification divides the causes into primary or secondary. Congenital abnormalities are much less common than acquired. The most common acquired TR is due to right ventricular dilatation. Such dilatation is most often due left heart failure or pulmonary hypertension. Other causes of right ventricular dilatation include right ventricular infarction, inferior myocardial infarction, and cor pulmonale. […] In regards to primary and secondary causes they are: Primary causes include Rheumatic, Myxomatous, Ebstein anomaly, Endomyocardial fibrosis, Endocarditis, and Traumatic (blunt chest injury). Secondary causes include Left ventricular systolic dysfunction, Mitral valve stenosis or regurgitation, Chronic lung disease, Pulmonary thromboembolism, Myocardial disease, Right ventricular ischemia and infarction, Left to right shunt, and Carcinoid heart disease.

• #59 Tricuspid valve regurgitation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/tricuspid-valve-regurgitation-1?case_id=tricuspid-regurgitation-echocardiography-1&lang=us

  Disorders leading to functional (secondary) tricuspid regurgitation include causes of left-sided heart failure (especially from mitral stenosis or mitral regurgitation), pulmonary hypertension, right ventricular myocardial infarction, left-to-right shunts, Eisenmenger syndrome, pulmonary stenosis, pulmonary regurgitation, and hyperthyroidism.

• #60 Tricuspid valve regurgitation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/tricuspid-valve-regurgitation-1?case_id=tricuspid-regurgitation-echocardiography-1&lang=us

  Disorders leading to functional (secondary) tricuspid regurgitation include causes of left-sided heart failure (especially from mitral stenosis or mitral regurgitation), pulmonary hypertension, right ventricular myocardial infarction, left-to-right shunts, Eisenmenger syndrome, pulmonary stenosis, pulmonary regurgitation, and hyperthyroidism.

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

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

  Tricuspid regurgitation usually presents with fatigue, dyspnea, and lower extremity edema. […] Mild or moderate tricuspid regurgitation without abnormal valve anatomy, ventricular function, or pulmonary artery pressure is not necessarily abnormal but is estimated to be present in over 50% of asymptomatic young adults. […] The clinically most important form is secondary to left-sided cardiac disease, with tricuspid annular dilation. […] Risk factors include left-sided heart failure, dilated tricuspid annulus, rheumatic heart disease, permanent pacemaker, endocarditis, carcinoid heart disease, pacemaker lead entrapment, ischemic cardiomyopathy, constrictive pericarditis, congenital heart disease, toxins, rheumatoid arthritis, radiation therapy, trauma, Marfan syndrome, and tricuspid valve prolapse.

• #62 Tricuspid Regurgitation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526121/

  Tricuspid regurgitation is a condition characterized by the backward flow of blood from the right ventricle into the right atrium during systole due to an incompetent tricuspid valve. This regurgitation often results from structural abnormalities of the valve apparatus, including issues with the valve leaflets, annulus, or papillary muscles. Contributing factors may include valve degeneration, annular dilation, or damage from conditions such as pulmonary hypertension or infective endocarditis. […] In tricuspid regurgitation, lesions fall into 2 categories: primary, where intrinsic abnormalities in the tricuspid valvular apparatus are responsible, and secondary, where right atrial or ventricular dilatation causes tricuspid regurgitation. The most common cause of tricuspid regurgitation is secondary or functional regurgitation. Secondary disorders like tricuspid annular dilation and leaflet tethering in right ventricular pressure and volume overload are largely responsible for tricuspid regurgitation compared to primary disorders involving the valve apparatus.

• #63 Tricuspid Regurgitation and Pulmonary Hypertension: What’s the Connection? | myPHteam

  https://www.myphteam.com/resources/tricuspid-regurgitation-and-pulmonary-hypertension

  Why does pulmonary hypertension cause tricuspid regurgitation? PH and TR are closely linked, with each condition making the other worse. When the right ventricle enlarges, it can affect how the tricuspid valve works. A poorly functioning valve forces the heart to work harder, which can make PH worse. Severe TR is tied to worsening PH and a higher risk of serious complications, including increased death rates. […] TR is classified as either primary or secondary based on its underlying cause. […] Primary, or organic, TR develops when there is direct damage to parts of the valve. Congenital conditions, infections, and trauma caused by the implantation of a pacemaker are all causes of this primary type of tricuspid valvular heart disease. […] Secondary, or functional, TR occurs when there is stretching or dilatation (widening or enlargement) of the part of the valve called the annulus, which is the ring of tissue where the valves leaflets sit. The leaflets are the parts that close together, and when their base becomes distended (stretched or swollen), they no longer close properly.

• #64 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. […] Structural changes to the right side of your heart cause most cases of moderate to severe tricuspid regurgitation. Such changes can occur when theres consistently too much pressure or blood in the right side of your heart. This overworks your right atrium and right ventricle, causing one or both to enlarge. […] Less often, tricuspid regurgitation results from abnormal or damaged valve leaflets. Healthcare providers call this form primary tricuspid regurgitation. It has many possible causes, ranging from medical conditions to trauma. […] Factors that can damage your tricuspid valve leaflets, leading to a leaky valve, include: Carcinoid syndrome, Atrial myxoma, Rheumatic heart disease, Infective endocarditis, Ebsteins anomaly and other congenital abnormalities, Myxomatous degeneration, which means your leaflets become thick and too stretchy and cant fully seal shut, Complications of implanted devices (like pacemakers), Radiation therapy to your chest, Severe traumatic injury to your chest (from a major car crash, for example), Certain medications.

• #65 Tricuspid Regurgitation – Cardiovascular Disorders – Merck Manual Professional Edition

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

  Tricuspid regurgitation may be […] Primary tricuspid regurgitation is less common. It can be due to […] Secondary tricuspid regurgitation is due to leaflet tethering, which is the result of reduced leaflet coaptation caused by annular dilation (typical of right atrial dilation caused by chronic atrial fibrillation) and/or papillary muscle displacement (most commonly as a result of left heart disease causing pulmonary hypertension and leading to RV dilation or geometric distortion). […] Long-standing severe TR may lead to RV dysfunctioninduced heart failure and atrial fibrillation.

• #66 Tricuspid Valve Regurgitation: What You NEED to Know

  https://myheart.net/articles/tricuspid-valve-regurgitation/

  In general tricuspid regurgitation can be thought of as primary or secondary. In primary tricuspid regurgitation the tricuspid valve leaflets or the chords that attach the valve to the heart pumping chambers themselves are affected. In secondary tricuspid regurgitation the leaflets and chords themselves are not primarily affected, rather there is a process called annular dilation. The annulus is the ring like structure in between the upper and lower chambers of the heart that houses the valve. When the annulus enlarges, it stretches the valve leaflets cannot meet together, so they can no longer act as a valve, and therefore blood leaks backward. […] Several things can cause primary tricuspid regurgitation, where the leaflets and/or chords are affected. These include valve infection, traumatic causes, birth defects and damage from pacemaker leads amongst other causes. Secondary tricuspid regurgitation is caused by factors leading to annulus enlargement, such as right ventricular failure or enlargement, or severely elevated pressures in the right side of the heart such as pulmonary hypertension. Even though the tricuspid valve is a right-sided heart structure, the most common cause of tricuspid regurgitation is actually left sided heart failure leading to congestion and subsequent right-sided problems!

• #67 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  More recently, moderate-to-severe isolated FTR was shown to be independently associated with excess mortality in FTR patients with preserved LVEF and pulmonary hypertension. […] The development of significant TR after left-sided valve surgery is not uncommon and is associated with an unfavourable outcome. […] In a series of patients with cardiomyopathy and advanced heart failure referred for heart transplantation, the presence of FTR predicted RV dilatation, RV dysfunction and unfavourable outcome. […] The presence of FTR predicted RV dilatation, RV dysfunction and unfavourable outcome. […] The decision on whom, how and when to treat should be based on a comprehensive understanding of the mechanism of FTR, its severity, the characteristics of the right ventricle, the pulmonary circulation, the loading conditions, and the presence/absence of rhythm disturbances.

• #68 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  More recently, moderate-to-severe isolated FTR was shown to be independently associated with excess mortality in FTR patients with preserved LVEF and pulmonary hypertension. […] The development of significant TR after left-sided valve surgery is not uncommon and is associated with an unfavourable outcome. […] In a series of patients with cardiomyopathy and advanced heart failure referred for heart transplantation, the presence of FTR predicted RV dilatation, RV dysfunction and unfavourable outcome. […] The presence of FTR predicted RV dilatation, RV dysfunction and unfavourable outcome. […] The decision on whom, how and when to treat should be based on a comprehensive understanding of the mechanism of FTR, its severity, the characteristics of the right ventricle, the pulmonary circulation, the loading conditions, and the presence/absence of rhythm disturbances.

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

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

  The causes of primary tricuspid regurgitation include infective endocarditis (especially in intravenous drug addicts, rheumatic heart disease, carcinoid syndrome, myxomatous disease, endomyocardial fibrosis, congenital valve dysplasia (eg, Ebsteins anomaly), thoracic trauma, and iatrogenic valve damage. […] Secondary tricuspid regurgitation is associated with left-sided valvular or myocardial dysfunction in most cases, whereas it is isolated in 8.1% of patients and independently related to mortality. […] Secondary tricuspid regurgitation may also develop late after left-sided valve surgery.

• #70 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  More recently, moderate-to-severe isolated FTR was shown to be independently associated with excess mortality in FTR patients with preserved LVEF and pulmonary hypertension. […] The development of significant TR after left-sided valve surgery is not uncommon and is associated with an unfavourable outcome. […] In a series of patients with cardiomyopathy and advanced heart failure referred for heart transplantation, the presence of FTR predicted RV dilatation, RV dysfunction and unfavourable outcome. […] The presence of FTR predicted RV dilatation, RV dysfunction and unfavourable outcome. […] The decision on whom, how and when to treat should be based on a comprehensive understanding of the mechanism of FTR, its severity, the characteristics of the right ventricle, the pulmonary circulation, the loading conditions, and the presence/absence of rhythm disturbances.

• #71 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  The only proven therapy for FTR is mechanical correction. […] Surgery is the most established therapy for FTR. […] The decision on whether to associate surgery for FTR in this group of patients is currently driven by the degree of FTR, the presence of significant annular dilatation, and/or right heart failure. […] Late onset of TR is frequent in patients who have undergone surgery for left-sided valvular lesions, and reoperation for FTR is characterised by high surgical risk. […] This has sparked the development of numerous percutaneous transcatheter devices. […] An important concept that needs to become widely accepted is that, when the annulus becomes dilated (planar and circular), it does not change after treatment of the primary cause of pressure or volume overload, thus implying that annular dilatation might be irreversible. […] Proven safe and efficacious percutaneous therapies for patients considered high-risk for surgical intervention. […] An evidence base for earlier surgical or percutaneous intervention of significant TR irrespective of symptoms.

• #72 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  The only proven therapy for FTR is mechanical correction. […] Surgery is the most established therapy for FTR. […] The decision on whether to associate surgery for FTR in this group of patients is currently driven by the degree of FTR, the presence of significant annular dilatation, and/or right heart failure. […] Late onset of TR is frequent in patients who have undergone surgery for left-sided valvular lesions, and reoperation for FTR is characterised by high surgical risk. […] This has sparked the development of numerous percutaneous transcatheter devices. […] An important concept that needs to become widely accepted is that, when the annulus becomes dilated (planar and circular), it does not change after treatment of the primary cause of pressure or volume overload, thus implying that annular dilatation might be irreversible. […] Proven safe and efficacious percutaneous therapies for patients considered high-risk for surgical intervention. […] An evidence base for earlier surgical or percutaneous intervention of significant TR irrespective of symptoms.

• #73 Etiology, epidemiology, pathophysiology and management of tricuspid regurgitation: an overview – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34957757/

  Significant tricuspid regurgitation (TR) is a common finding, affecting about one in twenty-five subjects among the elderly and presenting more frequently in women than in men. […] Classically, TR has been distinguished as primary and secondary or functional TR (FTR), with the latter being the most prevalent. FTR is a multifactorial disorder, resulting from maladaptive right ventricular remodeling secondary to pulmonary hypertension or from atrial fibrillation leading to dilation of the right atrium, tricuspid annulus and base of the right ventricle, with pathological TV coaptation. Thus two main types of FTR can be identified: pulmonary hypertension-FTR and idiopathic-FTR, depending on which factor, ventricular or atrial respectively, is the primum movens of the disease. […] Appreciable evidence suggests that significant TR leads to worsening prognosis regardless of the underlying etiology and should be addressed as a separate therapeutic target.

• #74 Etiology, epidemiology, pathophysiology and management of tricuspid regurgitation: an overview

  https://www.imrpress.com/journal/RCM/22/4/10.31083/j.rcm2204122

  Significant tricuspid regurgitation (TR) is a common finding, affecting about one in twenty-five subjects among the elderly and presenting more frequently in women than in men. This review summarizes data concerning etiology, epidemiology, pathophysiology and management strategies of TR. […] Classically, TR has been distinguished as primary and secondary or functional TR (FTR), with the latter being the most prevalent. FTR is a multifactorial disorder, resulting from maladaptive right ventricular remodeling secondary to pulmonary hypertension or from atrial fibrillation leading to dilation of the right atrium, tricuspid annulus and base of the right ventricle, with pathological TV coaptation. Thus two main types of FTR can be identified: pulmonary hypertension-FTR and idiopathic-FTR, depending on which factor, ventricular or atrial respectively, is the primum movens of the disease. […] Appreciable evidence suggests that significant TR leads to worsening prognosis regardless of the underlying etiology and should be addressed as a separate therapeutic target.

• #75 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  Tricuspid regurgitation (TR) is a frequently occurring valvular disease in the elderly population, the aetiology is functional in the vast majority of cases, and this valvular disease has become increasingly recognised as an independent predictor of morbidity and mortality. […] Moderate-to-severe TR is pathological and is caused by annular dilatation and/or leaflet abnormalities. […] Recent epidemiological data indicate that FTR accounts for 90% of all-comers with severe TR, and in total 65% of FTR occurs in the context of pulmonary hypertension. […] The pressure overload due to pulmonary hypertension that may or may not be associated with left-sided heart disease causes RV remodelling and tricuspid annular flattening and dilatation, eventually generating FTR. […] Cardiomyopathies with a dilated and hypokinetic phenotype can also produce per se an analogous remodelling process and eventually FTR.

• #76 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  Tricuspid regurgitation (TR) is a frequently occurring valvular disease in the elderly population, the aetiology is functional in the vast majority of cases, and this valvular disease has become increasingly recognised as an independent predictor of morbidity and mortality. […] Moderate-to-severe TR is pathological and is caused by annular dilatation and/or leaflet abnormalities. […] Recent epidemiological data indicate that FTR accounts for 90% of all-comers with severe TR, and in total 65% of FTR occurs in the context of pulmonary hypertension. […] The pressure overload due to pulmonary hypertension that may or may not be associated with left-sided heart disease causes RV remodelling and tricuspid annular flattening and dilatation, eventually generating FTR. […] Cardiomyopathies with a dilated and hypokinetic phenotype can also produce per se an analogous remodelling process and eventually FTR.

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

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

  Tricuspid regurgitation usually presents with fatigue, dyspnea, and lower extremity edema. […] Mild or moderate tricuspid regurgitation without abnormal valve anatomy, ventricular function, or pulmonary artery pressure is not necessarily abnormal but is estimated to be present in over 50% of asymptomatic young adults. […] The clinically most important form is secondary to left-sided cardiac disease, with tricuspid annular dilation. […] Risk factors include left-sided heart failure, dilated tricuspid annulus, rheumatic heart disease, permanent pacemaker, endocarditis, carcinoid heart disease, pacemaker lead entrapment, ischemic cardiomyopathy, constrictive pericarditis, congenital heart disease, toxins, rheumatoid arthritis, radiation therapy, trauma, Marfan syndrome, and tricuspid valve prolapse.

• #78 Tricuspid Regurgitation: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/158484-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 (eg, left ventricular [LV] dysfunction). […] Pure tricuspid regurgitation can be caused by at least 10 conditions, as follows: Rheumatic heart disease, Endocarditis, Ebstein anomaly, Tricuspid valve prolapse, Carcinoid, Papillary muscle dysfunction, Trauma, Connective-tissue diseases, Medications, RV dilatation. […] Tricuspid regurgitation secondary to rheumatic involvement is usually associated with mitral and aortic valve pathology. The valve develops diffuse fibrous thickening without commissural fusion, fused chordae, or calcific deposits.

• #79 Etiology, epidemiology, pathophysiology and management of tricuspid regurgitation: an overview – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34957757/

  Significant tricuspid regurgitation (TR) is a common finding, affecting about one in twenty-five subjects among the elderly and presenting more frequently in women than in men. […] Classically, TR has been distinguished as primary and secondary or functional TR (FTR), with the latter being the most prevalent. FTR is a multifactorial disorder, resulting from maladaptive right ventricular remodeling secondary to pulmonary hypertension or from atrial fibrillation leading to dilation of the right atrium, tricuspid annulus and base of the right ventricle, with pathological TV coaptation. Thus two main types of FTR can be identified: pulmonary hypertension-FTR and idiopathic-FTR, depending on which factor, ventricular or atrial respectively, is the primum movens of the disease. […] Appreciable evidence suggests that significant TR leads to worsening prognosis regardless of the underlying etiology and should be addressed as a separate therapeutic target.

• #80 Etiology, epidemiology, pathophysiology and management of tricuspid regurgitation: an overview

  https://www.imrpress.com/journal/RCM/22/4/10.31083/j.rcm2204122

  Significant tricuspid regurgitation (TR) is a common finding, affecting about one in twenty-five subjects among the elderly and presenting more frequently in women than in men. This review summarizes data concerning etiology, epidemiology, pathophysiology and management strategies of TR. […] Classically, TR has been distinguished as primary and secondary or functional TR (FTR), with the latter being the most prevalent. FTR is a multifactorial disorder, resulting from maladaptive right ventricular remodeling secondary to pulmonary hypertension or from atrial fibrillation leading to dilation of the right atrium, tricuspid annulus and base of the right ventricle, with pathological TV coaptation. Thus two main types of FTR can be identified: pulmonary hypertension-FTR and idiopathic-FTR, depending on which factor, ventricular or atrial respectively, is the primum movens of the disease. […] Appreciable evidence suggests that significant TR leads to worsening prognosis regardless of the underlying etiology and should be addressed as a separate therapeutic target.

• #81

  https://www.singhealth.com.sg/patient-care/conditions-treatments/tricuspid-valve-regurgitation

  Tricuspid valve regurgitation (also known as leaky heart valve), the tricuspid valve does not close properly resulting in blood leaking backwards from the right ventricle into the right atrium. […] When the tricuspid valve regurgitation becomes severe, it can lead to congestion in various organs such as the liver and the kidney, and affect their function. […] Severe tricuspid regurgitation has been shown to be associated with significant mortality and morbidity. […] In severe and long-standing cases, it can affect the function of various organs such as the liver and the kidney.

• #82 Tricuspid regurgitation: what is the real clinical impact and how often should it be treated? | EuroIntervention

  https://eurointervention.pcronline.com/article/tricuspid-regurgitation-what-is-the-real-clinical-impact-and-how-often-should-it-be-treated

  The only proven therapy for FTR is mechanical correction. […] Surgery is the most established therapy for FTR. […] The decision on whether to associate surgery for FTR in this group of patients is currently driven by the degree of FTR, the presence of significant annular dilatation, and/or right heart failure. […] Late onset of TR is frequent in patients who have undergone surgery for left-sided valvular lesions, and reoperation for FTR is characterised by high surgical risk. […] This has sparked the development of numerous percutaneous transcatheter devices. […] An important concept that needs to become widely accepted is that, when the annulus becomes dilated (planar and circular), it does not change after treatment of the primary cause of pressure or volume overload, thus implying that annular dilatation might be irreversible. […] Proven safe and efficacious percutaneous therapies for patients considered high-risk for surgical intervention. […] An evidence base for earlier surgical or percutaneous intervention of significant TR irrespective of symptoms.

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