tricuspid-regurgitation

TRICUSPID REGURGITATION (Circ 2014;129:2440; Lancet 2016;388:2431)

• Fxnl etiol (90%): RV dilation, PHT (may be 2° to L-sided dis.), large L → R shunts
• 1° etiol: myxomatous, IE, pacemaker leads, RHD, CTD, XRT, Ebstein’s, carcinoid, tumors
• Holosystolic murmur, 3rd/4th ICS, ↑ w/ insp (Carvallo’s sign); S3; prominent cv wave in JVP
• Consider repair/replacement in severe TR (eg, ERO ≥0.40 cm2) undergoing L-sided surgery, R heart failure or ? progressive RV dysfxn; emerging transcatheter Rx (JACC 2018;71:2935)