Tricuspid regurgitation stages: Difference between revisions
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==Stages== | ==Stages== | ||
{| | {| | ||
| Stage || Definition || Anatomy of the valve || Hemodynamics of the valve || Hemodynamic changes || Symptoms | | '''Stage''' || '''Definition''' || '''Anatomy of the valve''' || '''Hemodynamics of the valve''' || '''Hemodynamic changes''' || '''Symptoms''' | ||
|- | |- | ||
| A || At risk || Primary | | A || At risk || ''Primary''<br> | ||
* Mild rheumatic change | * Mild [[rheumatic]] change | ||
* Mild prolapse | * Mild prolapse | ||
* Findings related to other conditions (IE, carcinoid, radiation) | * Findings related to other conditions ([[IE]], [[carcinoid]], [[radiation]]) | ||
* | * Presence of an intra-annular RV [[pacemaker]] or [[ICD]] lead | ||
* Cardiac transplant (biopsy related) | * Cardiac [[transplant]] (biopsy related) | ||
Secondary | ''Secondary'' <br> | ||
* No | * No abnormal findings | ||
* Beginning of annular dilation | * Beginning of annular dilation | ||
| Absent | | Absent | ||
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| Absent | | Absent | ||
|- | |- | ||
| B || Progressive || Primary | | B || Progressive || ''Primary'' | ||
* Progressive leaflet deterioration/destruction | * Progressive leaflet deterioration/destruction | ||
* Moderate-to-severe prolapse and limited chordal rupture | * Moderate-to-severe prolapse and limited chordal rupture | ||
Secondary | ''Secondary'' | ||
* Beginning of annular dilation | * Beginning of annular dilation | ||
* Moderate leaflet tethering | * Moderate leaflet tethering | ||
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* Undefined width of vena contracta | * Undefined width of vena contracta | ||
* Soft and parabolic CW jet density and contour | * Soft and parabolic CW jet density and contour | ||
* Systolic dominance of hepatic vein flow | * [[Systolic]] dominance of [[hepatic vein]] flow | ||
Moderate TR | Moderate TR | ||
* Central jet area 5–10 cm2 | * Central jet area 5–10 cm2 | ||
* Undefined width of vena contracta width but <0.70 cm | * Undefined width of vena contracta width but <0.70 cm | ||
* Dense, variable CW jet density and contour | * Dense, variable CW jet density and contour | ||
* Systolic blunting of hepatic vein flow | * [[Systolic]] blunting of hepatic vein flow | ||
| Mild TR | | Mild TR | ||
* Normal size of RV/RA/IVC | * Normal size of RV/RA/IVC | ||
Moderate TR | Moderate TR | ||
* Absence of RV enlargement | * Absence of RV enlargement | ||
* Absent or mild RA enlargement | * Absent or mild [[RA]] enlargement | ||
* Absent or mild IVC enlargement with normal respirophasic variation | * Absent or mild [[IVC]] enlargement with normal respirophasic variation | ||
* Normal RA pressure | * Normal RA pressure | ||
| None | | None | ||
|- | |- | ||
| C || Asymptomatic severe || Primary | | C || Asymptomatic severe || ''Primary'' | ||
* Flail or grossly distorted leaflets | * Flail or grossly distorted leaflets | ||
Secondary | ''Secondary'' | ||
* Severe annular dilation (>40 mm or 21 mm/m2) | * Severe annular dilation (>40 mm or 21 mm/m2) | ||
* Marked leaflet tethering | * Marked leaflet tethering | ||
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* Vena contracta width >0.7 cm | * Vena contracta width >0.7 cm | ||
* Dense, triangular CW jet density and contour with early peak | * Dense, triangular CW jet density and contour with early peak | ||
* Systolic reversal in hepatic vein flow | * [[Systolic]] reversal in hepatic vein flow | ||
|* Dilated RV/RA/IVC and decreased IVC respirophasic variation | |* Dilated RV/RA/IVC and decreased [[IVC]] respirophasic variation | ||
* Increased RA pressure with “c-V” wave | * Increased RA pressure with “c-V” wave | ||
* Possible diastolic interventricular septal flattening | * Possible diastolic interventricular [[septal]] flattening | ||
| None | | None | ||
|- | |- | ||
| D || Symptomatic severe || Primary | | D || Symptomatic severe || ''Primary'' | ||
* Flail or grossly distorted leaflets | * Flail or grossly distorted leaflets | ||
Secondary | ''Secondary'' | ||
* Severe annular dilation (>40 mm or 21 mm/m2) | * Severe annular dilation (>40 mm or 21 mm/m2) | ||
* Marked leaflet tethering | * Marked leaflet tethering | ||
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* Dense, triangular CW jet density and contour with early peak | * Dense, triangular CW jet density and contour with early peak | ||
* Systolic reversal in hepatic vein flow | * Systolic reversal in hepatic vein flow | ||
|* Dilated RV/RA/IVC and decreased IVC respirophasic variation | |* Dilated RV/RA/IVC and decreased [[IVC]] respirophasic variation | ||
* Increased RA pressure with “c-V” wave | * Increased RA pressure with “c-V” wave | ||
* Possible diastolic interventricular septal flattening | * Possible diastolic interventricular septal flattening | ||
| Presence of symptoms ( | | Presence of symptoms ([[atigue]], [[dyspnea]], [[anorexia]], [[edema]], [[abdominal distention]], [[palpitations]]) | ||
|- | |- | ||
|} | |} |
Revision as of 13:58, 12 September 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Tricuspid Regurgitation Microchapters |
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Tricuspid regurgitation stages On the Web |
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Risk calculators and risk factors for Tricuspid regurgitation stages |
Overview
Stages
Stage | Definition | Anatomy of the valve | Hemodynamics of the valve | Hemodynamic changes | Symptoms |
A | At risk | Primary
Secondary
|
Absent | Absent | Absent |
B | Progressive | Primary
Secondary
|
Mild TR
Moderate TR
|
Mild TR
Moderate TR |
None |
C | Asymptomatic severe | Primary
Secondary
|
* Central jet area >10.0 cm2
|
* Dilated RV/RA/IVC and decreased IVC respirophasic variation
|
None |
D | Symptomatic severe | Primary
Secondary
|
* Central jet area >10.0 cm2
|
* Dilated RV/RA/IVC and decreased IVC respirophasic variation
|
Presence of symptoms (atigue, dyspnea, anorexia, edema, abdominal distention, palpitations) |