Tricuspid Stenosis
Tricuspid stenosis
Key pick up points
– Large a waves in JVP – Blunted Y descent in JVP – Mid-diastolic murmur – Pulsations in liver |
Tricuspid stenosis can coexist with mitral stenosis and usually manifests after the Percutaneous mitral valvotomy has been done. Patient will develop features of right sided heart failure.
Symptoms
- Ankle edema
- Abdominal fullness and discomfort
- Fatigue and effort intolerance
Examination findings
- Large a wave in JVP
- Blunted y descent
- Pulsatile liver (Pre-systolic pulsations of liver)
- Mid diastolic murmur that increases on deep inspiration. It is best heard at Left lower sternal border in tricuspid area
Work up
- ECG shows evidence of left atrial enlargement with P pulmonale and right axis deviation
- Echo shows thickened tricuspid valve. Severe tricuspid stenosis is size less than 1 cm and transit time across narrowed valve of > 190 msec.
- CXR show Enlarged Right atria and dilated Superior vena cava along with azygoz vein
Treatment
- Salt restricted diet
- Diuretics
- Valve repair or prosthetic valve deployment
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