Tricuspid regurgitation echocardiography
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Tricuspid regurgitation echocardiography On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
Transthoracic echocardiography (TTE) should be performed in a patient with suspected tricuspid regurgitation to confirm the diagnosis, determine the etiology, and to establish the baseline severity.
Echocardiography
Transthoracic echocardiogrpahy (TTE) is the diagnostic modality of choice to evaluate tricuspid regurgitation. TEE allows the evaluation of the following:[1]
- Right ventricle structure and function
- Right atrium structure and function
- Inferior vena cava
- The structure and function of the left chambers of the heart
- The structures of the tricuspid valve and the underlying etiology of mitral regurgitation
- Pulmonary artery pressure
- Pressures in the heart chambers
- The severity of the tricuspid regurgitation through the measurement of:
- The trucuspid annular diameter in the apical 4-chamber view
- Tricuspid valve leaflet tethering height
- Tricuspid valve leaflet tethering area
- Tricuspid regurgitation jet velocity signal
When TTE is non diagnostic, transesophageal echocardiography (TEE) may be performed. However, TEE is not provide an optimal way to assess the tricuspid valve.[1]
2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary[1]
| Class I |
| "1. TTE is indicated to evaluate severity of TR, determine etiology, measure sizes of right-sided chambers and inferior vena cava, assess RV systolic function, estimate pulmonary artery systolic pressure, and characterize any associated left-sided heart disease. (Level of Evidence: C)" |
| Class IIb |
| "1. CMR or real-time 3-dimensional echocardiography may be considered for assessment of RV systolic function and systolic and diastolic volumes in patients with severe TR (stages C and D) and suboptimal 2-dimensional echocardiograms. (Level of Evidence: C)" |
2008 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease - Evaluation of Tricuspid Valve Disease in Adolescents and Young Adults(DO NOT EDIT)[2]
| Class I |
| "1. Doppler echocardiography is indicated for the initial evaluation of adolescent and young adult patients with TR, and serially every 1 to 3 years, depending on severity. (Level C)" |
Sources
- 2008 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease [2]
References
- ↑ 1.0 1.1 1.2 Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". Circulation. 129 (23): 2440–92. doi:10.1161/CIR.0000000000000029. PMID 24589852.
- ↑ 2.0 2.1 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter
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