Tricuspid stenosis history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
Tricuspid stenosis is mostly associated with [[mitral valve]] abnormalities.<ref name="pmidPMID: 9665226">{{cite journal| author=Roguin A, Rinkevich D, Milo S, Markiewicz W, Reisner SA| title=Long-term follow-up of patients with severe rheumatic tricuspid stenosis. | journal=Am Heart J | year= 1998 | volume= 136 | issue= 1 | pages= 103-8 | pmid=PMID: 9665226 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9665226 }} </ref> Common symptoms include [[dyspnea]], [[peripheral edema]], and [[fatigue]]. | Tricuspid stenosis is mostly associated with [[mitral valve]] abnormalities.<ref name="pmidPMID: 9665226">{{cite journal| author=Roguin A, Rinkevich D, Milo S, Markiewicz W, Reisner SA| title=Long-term follow-up of patients with severe rheumatic tricuspid stenosis. | journal=Am Heart J | year= 1998 | volume= 136 | issue= 1 | pages= 103-8 | pmid=PMID: 9665226 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9665226 }} </ref> Common symptoms include [[dyspnea]], [[peripheral edema]], and [[fatigue]]. | ||
Tricuspid stenosis (TS) is narrowing of the tricuspid orifice that obstructs blood flow from the right atrium to the right ventricle. Almost all cases result from rheumatic fever. Symptoms include a fluttering discomfort in the neck, fatigue, cold skin, and right upper quadrant abdominal discomfort. Jugular pulsations are prominent, and a presystolic murmur is often heard at the left sternal edge in the 4th intercostal space and is increased during inspiration. | Tricuspid stenosis (TS) is the narrowing of the tricuspid orifice that obstructs blood flow from the right atrium to the right ventricle. Almost all cases result from rheumatic fever. Symptoms include a fluttering discomfort in the neck, fatigue, cold skin, and right upper quadrant abdominal discomfort. Jugular pulsations are prominent, and a presystolic murmur is often heard at the left sternal edge in the 4th intercostal space and is increased during inspiration. The diagnosis is by echocardiography. TS is usually benign, requiring no specific treatment, but symptomatic patients may benefit from surgery. | ||
==History== | ==History== | ||
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*Tricuspid stenosis is almost always due to rheumatic fever; tricuspid regurgitation is almost always also present, as is rheumatic mitral valvulopathy<ref name="pmid31367735">{{cite journal |vauthors=Hirata K, Tengan T, Wake M, Takahashi T, Ishimine T, Yasumoto H, Nakasu A, Mototake H |title=Bioprosthetic tricuspid valve stenosis: a case series |journal=Eur Heart J Case Rep |volume=3 |issue=3 |pages= |date=September 2019 |pmid=31367735 |pmc=6764547 |doi=10.1093/ehjcr/ytz110 |url=}}</ref>. | *Tricuspid stenosis is almost always due to rheumatic fever; tricuspid regurgitation is almost always also present, as is rheumatic mitral valvulopathy<ref name="pmid31367735">{{cite journal |vauthors=Hirata K, Tengan T, Wake M, Takahashi T, Ishimine T, Yasumoto H, Nakasu A, Mototake H |title=Bioprosthetic tricuspid valve stenosis: a case series |journal=Eur Heart J Case Rep |volume=3 |issue=3 |pages= |date=September 2019 |pmid=31367735 |pmc=6764547 |doi=10.1093/ehjcr/ytz110 |url=}}</ref>. | ||
*Rare causes of tricuspid stenosis include systemic lupus erythematosus, right atrial myxoma, congenital malformations, and metastatic tumors. | *Rare causes of tricuspid stenosis include systemic lupus erythematosus, right atrial myxoma, congenital malformations, and metastatic tumors. | ||
*The right atrium becomes hypertrophied and distended, and sequelae of right heart | *The right atrium becomes hypertrophied and distended, and sequelae of right heart disease-induced heart failure develop but without right ventricular (RV) dysfunction; the RV remains underfilled and small. | ||
*Uncommonly, atrial fibrillation occurs. | *Uncommonly, atrial fibrillation occurs. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]
Overview
Tricuspid stenosis is mostly associated with mitral valve abnormalities.[1] Common symptoms include dyspnea, peripheral edema, and fatigue. Tricuspid stenosis (TS) is the narrowing of the tricuspid orifice that obstructs blood flow from the right atrium to the right ventricle. Almost all cases result from rheumatic fever. Symptoms include a fluttering discomfort in the neck, fatigue, cold skin, and right upper quadrant abdominal discomfort. Jugular pulsations are prominent, and a presystolic murmur is often heard at the left sternal edge in the 4th intercostal space and is increased during inspiration. The diagnosis is by echocardiography. TS is usually benign, requiring no specific treatment, but symptomatic patients may benefit from surgery.
History
- Tricuspid stenosis is almost always due to rheumatic fever; tricuspid regurgitation is almost always also present, as is rheumatic mitral valvulopathy[2].
- Rare causes of tricuspid stenosis include systemic lupus erythematosus, right atrial myxoma, congenital malformations, and metastatic tumors.
- The right atrium becomes hypertrophied and distended, and sequelae of right heart disease-induced heart failure develop but without right ventricular (RV) dysfunction; the RV remains underfilled and small.
- Uncommonly, atrial fibrillation occurs.
Signs and Symptoms
- The only symptoms of severe tricuspid stenosis are fluttering discomfort in the neck (due to giant a waves in the jugular pulse), fatigue and cold skin (due to low cardiac output), and right upper quadrant abdominal discomfort (due to an enlarged liver)[3].
- The primary visible sign is a giant flickering a wave with gradual y descent in the jugular veins.
- Jugular venous distention may occur, increasing with inspiration (Kussmaul sign).
- The face may become dusky and scalp veins may dilate when the patient is recumbent (suffusion sign).
- Hepatic congestion and peripheral edema may occur.
other symptoms includes:
- Fatigue
- Dyspnea[1][4]
- Abdominal discomfort (due to hepatomegaly secondary to systemic venous congestion)
- Pedal edema
- Jugular venous distension
- Heart murmur
References
- ↑ 1.0 1.1 Roguin A, Rinkevich D, Milo S, Markiewicz W, Reisner SA (1998). "Long-term follow-up of patients with severe rheumatic tricuspid stenosis". Am Heart J. 136 (1): 103–8. PMID 9665226 PMID: 9665226 Check
|pmid=value (help). - ↑ Hirata K, Tengan T, Wake M, Takahashi T, Ishimine T, Yasumoto H, Nakasu A, Mototake H (September 2019). "Bioprosthetic tricuspid valve stenosis: a case series". Eur Heart J Case Rep. 3 (3). doi:10.1093/ehjcr/ytz110. PMC 6764547 Check
|pmc=value (help). PMID 31367735. - ↑ Golamari R, Bhattacharya PT. PMID 29763166. Missing or empty
|title=(help) - ↑ KOSSMANN CE (March 1955). "The opening snap of the tricuspid valve: a physical sign of tricuspid stenosis". Circulation. 11 (3): 378–90. doi:10.1161/01.cir.11.3.378. PMID 14352381.