Condition- Tricuspid Regurgitation Flashcards

1
Q

What is tricuspid regurgitation?

A

Backflow of blood from the RV to the RA across the tricuspid valve during systole

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2
Q

List some causes of tricuspid regurgitation- which is the most common

A
  • CONGENITAL:
    • Ebstein’s anomaly (malpositioned tricuspid valve)
    • Cleft valve in ostium primum)
  • FUNCTIONAL
    • RV dilation due to pulmonary hypertension
    • Valve prolapse
  • Rheumatic heart disease
  • Infective endocarditis (in IVD)
  • Other: carcinoid syndrome, cirrhosis
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3
Q

List some of the presenting symptoms of tricuspid regurgitation

A

Learn Symptoms By Just Nailing Acronyms: Tricuspid Errors Produce Heart Palpitations

  • Leg Swelling/ Ascites/ Oedema (fluid retention symptoms)
  • Breathlessness
  • Jaundice
  • Nausea
  • Anorexia
  • Tiredness
  • Epigastric Pain (made worse by exercise)
  • Headache
  • Palpitations
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4
Q

What might you hear on auscultation of a patient with tricuspid regurgitation?

A
  • Pansystolic murmur heard at lower left sternal border
    • Louder on inspiration
  • Louder P2 component of second heart sound
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5
Q

What other signs might you see on physical examination of a patient with tricuspid regurgitation

A
  • irregularly irregular pulse
  • I: Raised JVP (which may oscillate the earlobes)
  • P: Parasternal heaves
  • A: Pansystolic murmur louder on inspiration
  • Chest: pleural effusion
  • Abdo: palpable liver, ascites, jaundice
  • Legs: pitting oedema
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6
Q

Which investigation is required to accurately diagnose and assess the cause and severity of tricuspid regurg

A

Echocardiogram

May show valve prolapse + right v dilation

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7
Q

What might you see on an ECG of a patient with TR?

A

P pulmonale due to right atrial hypertrophy

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8
Q

List some investigations you could conduct on a patient with TR?

A
  • BEDSIDE: ECG= p-mitrale
  • BLOODS: FBC, LFT, cardiac enzymes, blood cultures
  • IMAGING:
    • CXR= right sided enlargement of cardiac shadow
    • Echo
    • Right hear catheterisation= pulmonary artery pressure
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