Clinical Recognition of Tricuspid Valve Disease

Tricuspid valve (TV) dysfunction can result from morphological alterations in the valve or from functional aberrations of the myocardium. It can be classified as primary and secondary. Primary TV disease with intrinsic structural abnormality is less common than diseases of the aortic and mitral valves. The slow progression of the disease leads to delayed appearance of symptoms. The physical signs are often less impressive. Hence, it may go undetected until advanced stage results in hepatomegaly, ascites, and leg edema. The secondary form of TV disease is far more common and is often the result of annular dilatation with incomplete valve closure. The functional abnormalities may be in the form of pure or predominant tricuspid stenosis (TS), pure or predominant tricuspid regurgitation (TR), or mixed.