Tricuspid Valve Disease: A Patient Guide

1. What Is the Tricuspid Valve?

The tricuspid valve lies between the right atrium and the right ventricle. It keeps blood moving in one direction, preventing backflow into the right atrium as the right ventricle pumps oxygen-poor blood towards the lungs.

2. What Causes Tricuspid Valve Disease?

Tricuspid valve disease may involve narrowing of the valve (stenosis) or leakage through a valve that does not close properly (regurgitation).

Other causes and associated conditions include:

• Rheumatic heart disease
• Heart failure and enlargement of the right heart chambers
• Raised pressure in the lung circulation associated with lung disease (pulmonary hypertension)
• Infective endocarditis (infection of a heart valve)
• Congenital heart disease
• Valve damage related to pacemaker leads or catheters
• Trauma and, rarely, tumours

3. What Are the Symptoms?

Tricuspid valve disease may cause no symptoms for a long time. As it progresses, symptoms can include:

• Weakness and becoming tired easily
• Swelling of the legs and feet (oedema)
• Abdominal swelling and fluid accumulation (ascites)
• Prominent neck veins
• Shortness of breath
• Palpitations
• Liver enlargement and digestive problems in advanced disease

4. How Is It Diagnosed?

Assessment may include the following:

• Physical examination, including listening for a heart murmur
• Echocardiography (heart ultrasound), the main diagnostic test
• Electrocardiography (ECG)
• Chest X-ray
• Cardiac MRI or catheterisation when needed

5. What Are the Treatment Options?

Treatment depends on the severity and cause of the valve disease, symptoms, heart function and the patient's overall health.

a) Medicines

• Diuretics to reduce fluid retention
• Treatment for heart failure
• Medicines for heart rhythm problems when indicated
• Antibiotics when a bacterial infection requires treatment

b) Catheter-Based Procedures

• Tricuspid valve repair using edge-to-edge techniques
• Transcatheter valve replacement in selected patients, according to anatomy, device availability and specialist assessment

These procedures may be considered particularly when surgical risk is high. A specialist heart team assesses whether a catheter procedure is suitable.

c) Surgery

• Tricuspid valve repair, preferred when a durable repair is feasible
• Tricuspid valve replacement with a tissue or mechanical valve when repair is not suitable

Surgery may be recommended for severe regurgitation or considered during another indicated heart operation. Timing is decided individually.

6. Outlook

Tricuspid valve disease can go unnoticed in its early stages but may cause serious problems as it advances. Timely assessment and treatment of associated mitral valve disease and other underlying conditions can help limit strain on the right heart. Appropriate follow-up and treatment may improve symptoms and quality of life.

Frequently Asked Questions