Tricuspid valve disease is a heart disease in which the valve linking the two right heart chambers (right ventricle and right atrium) breaks down, and blood leaks backward into the right atrium (upper right chamber). Moreover, other cardiac valve problems are also linked to tricuspid valve failure.
Types of Tricuspid Valve disease
There are several types of tricuspid valve disease, including:
1. Ebstein anomaly:
Ebstein anomaly is a congenital cardiac condition in which the tricuspid valve is defective and lies lower than usual in the right ventricle. Blood may flow back into the right atrium due to tricuspid valve disease.
2. Tricuspid valve regurgitation:
Tricuspid valve regurgitation occurs when the tricuspid valve fails to shut properly, allowing blood to flow backward into the upper right chamber of your heart (right atrium).
3. Tricuspid atresia:
This is a congenital heart abnormality (birth defect) in which the tricuspid valve does not develop properly. In this case, the blood flow between your right heart chambers is blocked by a solid sheet of tissue.
4. Tricuspid Valve Stenosis:
The tricuspid valve narrows, which restricts blood flow from the right upper chamber (right atrium) to the lower right heart chamber (right ventricle).
Tricuspid Valve Causes
Following are the causes of Tricuspid valve disease;
1. Disorders of the genes:
Marfan syndrome is a connective tissue illness that can cause tricuspid valve regurgitation in some people.
2. Rheumatic fever:
The tricuspid valve and other heart valves can be damaged by untreated strep throat, resulting in valve regurgitation later in life.
3. Infective endocarditis:
The tricuspid valve can be damaged by an infection of the heart’s lining.
4. Birth malformations in the heart (congenital heart defects):
The form and function of the tricuspid valve can be affected by some congenital cardiac abnormalities. Ebstein anomaly is an uncommon congenital cardiac condition that causes tricuspid valve regurgitation in youngsters. The tricuspid valve is faulty in tricuspid valve disease, and it rests lower than usual in the right ventricle.
5. Chest injury(trauma):
Confront trauma to the chest due to various life-threatening incidents in life such as car accidents, can cause damage to the tricuspid valve, resulting in tricuspid valve regurgitation.
6. Endomyocardial (heart muscle) biopsy:
In this biopsy, a tiny sample of cardiac muscle tissue is taken to analyze the symptoms of inflammation or infection. Sometimes, valve damage can occur during this procedure.
7. Radiation therapy:
It is a type of treatment that involves giving radiation to the chest, such as during cancer therapy, which can damage the tricuspid valve, resulting in tricuspid valve regurgitation.
8. Carcinoid syndrome (type of cancer):
Sometimes, tumors in the digestive system extend to the liver or lymph nodes and release a hormone-like substance that can damage heart valves, most often the tricuspid and pulmonary valves.
9. Pacemaker or a cardiac device wire:
It is sometimes possible that the implantation or removal of pacemaker and defibrillator wires span the tricuspid valve and cause tricuspid valve regurgitation.
Risk factors:
Following are the several factors that can increase the risk of tricuspid valve regurgitation;
- Ebstein abnormality and other congenital cardiac abnormalities.
- Heart attack and heart failure.
- Hypertension (high blood pressure).
- Pulmonary hypertension (hypertension of the blood vessels in the lungs).
- Heart Infections, such as rheumatic fever and infective endocarditis.
- Chest radiation.
- Use of some stimulants and drugs for Parkinson’s disease and migraines.
- Heart muscle weakness (cardiomyopathy).
Tricuspid Valve Signs and Symptoms:
Tricuspid valve disease can sometimes occur without symptoms for a long time.
However, it can diagnose by conducting a specific test for any other disease. Following are the potential signs and symptoms of tricuspid valve disease;
- Atrial fibrillation (abnormal heartbeat)
- Fatigue
- Right abdominal pain
- Shortness of breath
- Swelling in the legs or abdomen
- Cold skin
Tricuspid Valve Diagnosis:
A physical examination can be used to diagnose tricuspid valve disease in which a doctor may hear an abnormal blood flow through the valves that are also known as a murmur. An uneven pulse and fluttering or irregular pulsation in your neck (jugular vein) are two more indicators that your doctor may notice.
The following tests may be performed to diagnose tricuspid valve disease;
- Electrocardiography (ECG)
- Chest X-ray
- Cardiac catheterization angiography
- Radionuclide scanning
- Magnetic resonance imaging (MRI)
Tricuspid Valve Treatment
1. Medical Treatment:
Your doctor will probably want regular appointments to monitor the progress of your valve disease. Sometimes, the doctor feels the need and urgency of more frequent visits. In that case, they will definitely ask you to visit regularly, either weekly, monthly, or quarterly, depending upon the causes and severity of the disease.
Your appointment will include a complete medical exam in which diagnostic tests may be repeated at regular intervals.
Your physician may prescribe medications to treat the symptoms of tricuspid valve disease. These medications may include drugs to treat heart failure or control irregular heart rhythms.
2. Surgical Treatment:
a. Tricuspid Valve Repair:
The diseased valve may need to be repaired or replaced in extremely severe diseases. The ideal surgical technique for tricuspid regurgitation is tricuspid valve repair with an annuloplasty ring, which can be done for primary tricuspid disease or in combination with other valve surgeries (mitral, aortic). A valve replacement will be performed if the valve cannot be repaired.
b. Preventing endocarditis:
Endocarditis is an infection that damages the heart valves. Specifically, it is dangerous for people with tricuspid valve dysfunction (even if your valve has been repaired or replaced with surgery).
Guidelines for surgery:
You must adhere to the following rules:
- Inform your dentist and doctors that you have valve disease to go further to treat any other illness.
- If you have symptoms of an infection such as sore throat, general body achiness, and fever, immediately contact your doctor to discuss the medical concerns in detail and get the treatment accordingly.
- To avoid infections, take proper care of your teeth and gums.
- Visit your dentist at least once a year.
Antibiotics should be used before any procedure that could result in bleeding, such as;
- Any dental procedures, even basic teeth cleaning.
- Intrusive examinations.
- Any other major and minor surgeries.
- Consult your doctor to determine the type and dosage of antibiotics you should take.
References:
- https://www.mayoclinic.org/diseases-conditions/tricuspid-valve-regurgitation/symptoms-causes/syc-20350168 retrieved on March 02, 2022.
- https://my.clevelandclinic.org/health/diseases/17578-tricuspid-valve-disease retrieved on March 02, 2022.
- https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/tricuspid-regurgitation retrieved on March 02, 2022.
