Station 3.5: Tricuspid incompetence Flashcards

Question 1

Q

Clinical signs

What are the clinical signs of Tricuspid incompetence?

Tricuspid incompetence

Examine this patient’s cardiovascular system. He has been complaining of abdominal discomfort

Answer

A

Raised JVP with giant CV waves
Thrill left sternal edge
Auscultation
⚬ Pan-systolic murmur (PSM) loudest at the tricuspid area (lower left sternal edge) in inspiration.
⚬ Reverse split second heart sound due to rapid RV emptying.
⚬ Right ventricular rapid lling gives an S3.
Pulsatile liver, ascites and peripheral oedema
Endocarditis from IV drug abuse: needle marks
Pulmonary hypertension: RV heave and loud P2
Other valve lesions: rheumatic mitral stenosis

Question 2

Q

Discussion - causes

What are the causes of Tricuspid incompetence?

Tricuspid incompetence

Examine this patient’s cardiovascular system. He has been complaining of abdominal discomfort

Answer

A

Congenital: Ebstein’s anomaly (atrialization of the right ventricle and TR)
Acquired:
⚬ Acute: infective endocarditis (IV drug user)
⚬ Chronic: functional (commonest), rheumatic and carcinoid syndrome

Question 3

Q

Discussion - investigation

What investigations do you recommend for Tricuspid incompetence?

Tricuspid incompetence

Examine this patient’s cardiovascular system. He has been complaining of abdominal discomfort

Answer

A

Question 4

Q

Discussion - investigation

What investigations do you recommend for Tricuspid incompetence?

Tricuspid incompetence

Examine this patient’s cardiovascular system. He has been complaining of abdominal discomfort

Answer

A

Question 5

Q

Discussion - management

What management do you recommend for Tricuspid incompetence?

Tricuspid incompetence

Examine this patient’s cardiovascular system. He has been complaining of abdominal discomfort

Answer

A

Medical: diuretics, β‐blockers, ACE inhibitors and support stockings for oedema
Surgical: valve repair/annuloplasty if medical treatment fails

Tricuspid incompetence (5 cards)