Tricuspid stenosis is a narrowing of the tricuspid valve, which controls blood flow from the right atrium to the right ventricle. When the valve opening is narrowed, the right atrium must work harder to push blood through the restricted orifice, leading to a rise in right atrial pressure and reduced filling of the right ventricle.
Tricuspid stenosis is the least common of the major adult valve stenoses. The most common cause is rheumatic heart disease, where inflammation following rheumatic fever causes progressive thickening, fusion, and calcification of the valve leaflets over many years. Rheumatic tricuspid stenosis rarely occurs in isolation and is usually found alongside mitral and sometimes aortic valve disease. Congenital tricuspid stenosis is rare.
Symptoms of significant tricuspid stenosis include fatigue, abdominal swelling (due to liver congestion from elevated right atrial pressure), ankle and leg oedema, and a characteristic low-pitched diastolic murmur at the lower left sternal border. The enlarged right atrium is a risk factor for atrial fibrillation, which further reduces cardiac output. Diagnosis is confirmed by echocardiography.
Treatment depends on severity and overall valve condition. Balloon valvuloplasty (transcatheter dilation of the valve) may be effective for pliable valves, while surgical repair or tricuspid valve replacement is required for severely deformed or calcified valves, particularly when other valve surgery is being performed at the same time.
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