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Tricuspid Regurgitation


What is tricuspid regurgitation (TR)?

TR is a condition that causes blood to leak backwards through the tricuspid valve to the right atrium. This happens because the tricuspid valve does not close properly. The tricuspid valve is between the right atrium and the right ventricle of your heart. The right atrium pumps blood into your right ventricle. The tricuspid valve opens to allow blood from your right atrium into your right ventricle. Normally, it closes when your right ventricle pumps blood to the lungs.

Heart Chambers

What increases my risk for TR?

TR often happens when your ventricle is enlarged. The following can increase your risk for damage:

  • Rheumatic fever or an infection of your tricuspid valve
  • A heart tumor or congenital heart problems
  • An injury to your tricuspid valve from chest trauma, a heart procedure, or radiation
  • Blunt chest trauma, such as your chest hitting the steering wheel in an accident
  • Use of certain medicines that help you lose weight
  • Rheumatoid arthritis or Marfan syndrome

What are the signs and symptoms of TR?

You may not have symptoms or you may have any of the following:

  • Being able to see your neck veins move or pulse
  • Weakness or fatigue
  • Shortness of breath that gets worse during activity or when you lie down
  • Enlarged liver
  • Swelling in your abdomen, legs, ankle, or feet

How is TR diagnosed?

Your healthcare provider will examine you. Tell him or her if you have any heart or lung conditions. Also tell him or her if you take medicine to help you lose weight. You may also need any of the following:

  • X-ray or MRI pictures may show an enlarged heart or problems with your valve or lungs. You may be given contrast liquid to help the heart and lungs show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • An echocardiogram is a type of ultrasound. It is used to show problems with your tricuspid valve and how blood flows through your heart. It may also show how well your heart is pumping. You may need a transthoracic or transesophageal echocardiogram. Ask your healthcare provider about these types of echocardiogram.
  • A stress test helps healthcare providers see how well your tricuspid valve works under stress. Healthcare providers may place stress on your heart with exercise or medicine.
  • A cardiac catheterization is a procedure to check how well your heart is working. It is also used to measure pressure in different parts of your heart. Ask your healthcare provider for more information.

How is TR treated?

Treatment may not be needed if your condition does not cause symptoms. Medicines may be given to treat your symptoms. You may need medicines to remove extra fluid, treat an infection, or decrease lung pressure. Your tricuspid valve may be repaired or replaced if it causes severe symptoms. Replacement is a surgery to remove your tricuspid valve. A new valve is then secured in place. The new valve may be from a donor (another person or animal), or may be an artificial valve. There are 2 different approaches for valve replacement. The first is an open heart procedure. The second is a procedure that replaces the valve through a catheter guided into a vessel in your groin. Your healthcare provider will talk to you about which approach is right for you.

What can I do to manage my symptoms?

  • Maintain a healthy weight. Being overweight can increase your risk for high blood pressure and coronary artery disease. These conditions can make your heart work harder. Ask your healthcare provider how much you should weigh. Ask him or her to help you create a weight loss plan if you are overweight.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Do not drink alcohol. Ask your cardiologist if it is safe for you to drink alcohol. Alcohol can increase your risk for high blood pressure, liver problems, and coronary artery disease.
  • Eat heart-healthy foods and limit sodium (salt). Eat more fresh fruits and vegetables. Eat fewer canned and processed foods. Replace butter and margarine with heart-healthy oils such as olive oil and canola oil. Other heart-healthy foods include walnuts, whole-grain breads, low-fat dairy products, beans, and lean meats. Fatty fish such as salmon and tuna are also heart healthy. Ask how much salt you can eat each day. Too much salt can cause fluid to buildup in your body. This can increase stress on your heart.
  • Exercise as directed. Exercise can help keep your heart healthy. Ask your healthcare provider what activities are safe for you to do. The amount and type of exercise that is safe may depend on your symptoms. It may also depend on how severe your condition is.
  • Talk to your healthcare provider about pregnancy. If you are a woman and want to get pregnant, talk to your healthcare provider. You and your baby may need to be monitored by specialists during your pregnancy.
  • Ask your healthcare provider if you should take antibiotics before certain procedures. Some procedures may allow bacteria to get into your blood and travel to your heart. This can make your condition worse.

Call 911 or have someone else call if:

You have any of the following signs of a heart attack:

  • Squeezing, pressure, or pain in your chest
  • and any of the following:
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Shortness of breath
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat

When should I seek immediate care?

  • You have new or worse swelling in your abdomen, legs, ankles, or feet.
  • Your heart is beating slower or faster than usual.
  • Your symptoms increase.

When should I contact my healthcare provider?

  • You have a fever.
  • Your appetite decreases.
  • You lose weight or gain 3 pounds or more in one day.
  • Your skin or eyes look yellow.
  • You have a new cough that does not go away within 3 days.
  • You are pregnant or think you are pregnant.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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