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What to Know About Tricuspid Valve Disease

Medically Reviewed by Mahammad Juber, MD on August 30, 2022

Tricuspid valve disease is a heart condition that can range in terms of severity. Some people are born with it, and some develop it later on in life through things like infection, disease, or trauma. Fortunately, it’s a treatable condition that many people live with. 

Treatment depends on how it started and how severe your case is. 

What Is Tricuspid Valve Disease?

Your heart keeps blood pumping through your whole body and is divided into four chambers: 

  • Right atrium (upper right side)
  • Right ventricle (lower right side)
  • Left atrium (upper left side) 
  • Left ventricle (lower left side)

These chambers are divided by thin walls and your heart’s valves. The valves pump blood to each section at a rhythmic, steady pace when working correctly. 

Blood that’s already been circulated through your body re-enters your heart through the right atrium. It moves through the tricuspid valve to the right ventricle. Then, it’s pumped into the lungs to collect more oxygen. Once it’s been oxygenated, it continues to the left side to be distributed throughout the body. 

There are a few different ways your tricuspid valve can malfunction, so there are different types of tricuspid valve disease: 

  • Tricuspid atresia. This is a birth defect. There isn’t a tricuspid valve in the heart, just a thin wall of tissue between the right atrium and ventricle. Most of the time, an affected baby will need surgery to keep their heart working properly. 
  • Tricuspid regurgitation. The tricuspid valve needs to close tightly when sending blood between the right atrium and ventricle. Tricuspid regurgitation happens when the valve doesn’t close properly, sending blood back into the right atrium and causing a build-up of blood pressure in the area. 
  • Tricuspid stenosis. The tricuspid valve is very narrow, which means less blood moves through the heart and gets circulated into the body. A buildup of blood in the right atrium can also result in it becoming stretched larger and damaged. 

Symptoms of Tricuspid Valve Disease

Sometimes, mild tricuspid valve disease doesn’t come with any symptoms. Other times, babies born with the disease might have: 

  • Bluish-colored skin or lips
  • Consistent fatigue or tiredness
  • Shortness of breath or breathing abnormalities

It’s possible for heart abnormalities in babies to be detected with an ultrasound before they’re born. Discovering the condition early can give you time to prepare and discuss treatment options with your healthcare provider.  

When adults have a moderate to severe case of tricuspid valve disease, there will be noticeable symptoms. That can include: 

  • Fatigue 
  • A strong pulse or flutter in the neck 
  • Abnormal swelling in the hands, feet, or stomach (edema)
  • Irregular heart rhythm or heart murmur 
  • Skin that’s cold to the touch
  • Difficulty taking full breaths 
  • Swollen or enlarged liver 

What Causes Tricuspid Valve Disease in Adults? 

Flaps of tissue on the heart valves are known as leaflets, and they help regulate blood flow between the heart’s chambers. Infection can cause these leaflets to become damaged or lose their proper shape. That can result in blood circulation problems in the heart. 

Some conditions that can develop into tricuspid valve disease are: 

  • General weakness of the heart muscle
  • Heart failure
  • High blood pressure in the lungs (pulmonary hypertension)
  • Trauma from a heart attack or surgery 
  • Cancer and radiation treatment
  • Autoimmune diseases like lupus or rheumatoid arthritis 
  • Certain medications 

Tricuspid valve disease can happen at the same time as other heart valve conditions. 

Rheumatic fever can cause tricuspid valve disease too. Rheumatic fever infections are now rare in the U.S, though, so this cause is not seen very often. 

Diagnosing Tricuspid Valve Disease

People who suspect they have tricuspid valve disease will usually undergo a physical examination and several tests to get an accurate diagnosis. 

During the physical exam, your doctor will look for irregularities in your heart rate, pulse rate, and blood pressure. They may ask you about any medications you’re taking and about your medical history. If you’re having symptoms consistent with tricuspid valve disease, they can order tests to take a closer look. 

Imaging tests are the best way to look at what’s happening on the inside of your heart. Your doctor will try to get the most accurate images by recommending you undergo one or several of the following tests: 

  • EKG (electrocardiogram), 
  • Chest x-ray 
  • Heart MRI
  • Coronary angiogram
  • Echocardiogram (echo) 
  • Transesophageal echocardiography
  • Blood tests

Tricuspid Valve Disease Treatment

Once you’ve been diagnosed with tricuspid valve disease, the treatment will vary based on the severity of the disease and if there are any other complications. 

Most cases are treated with medication, surgery, or a combination of the two. 

Medication. Medication can help manage symptoms in mild cases. It can do this by treating symptoms or the underlying condition, which helps the tricuspid valve to function properly. This treatment might include medication that: 

  • Decreases your blood’s ability to clot (anticoagulants)
  • Sustains a regularly patterned heartbeat (anti-arrhythmic)
  • Relaxes the veins and arteries (ACE inhibitors)
  • Expels extra water from the body (diuretics) 
  • Treats irregular heartbeats and heart failure 

Surgery. In serious cases, surgery could be your best option for recovery. Depending on how severe your case is, your healthcare team could recommend tricuspid valve repair or valve replacement surgery. 

Valve repair is usually less invasive. The surgeon will repair damages to the valve, leaflets, or tissue-based flaps. 

Valve replacement surgery involves new valves, either made from biological sources like your own tissue or tissue from a donor, or a metal valve installed into your heart.

Your doctor will talk to you about the best options for your individual case and how to best move forward. 

With any treatment option, you’ll need to follow up with your doctor to monitor your condition. Afterward, many people who take medication or have surgery for tricuspid valve disease live normal lives. 

Show Sources

SOURCES: 

Cleveland Clinic: “Blood Flow Through The Heart,””Tricuspid Valve Disease.”

Mayo Clinic: “Tricuspid valve disease.”

The Society of Thoracic Surgeons, ​​The Patient Guide to Heart, Lung, and Esophageal Surgery: “Tricuspid Valve Disease.”

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