Tricuspid Valve Stenosis

Definition

Tricuspid valve stenosis is a narrowing or stiffening of the opening in the valve. This stenosis causes increased resistance to blood flow through the valve.

Description

The tricuspid valve is located between the right atrium and the right ventricle of the heart. It is the largest of the four valves in the heart. When the tricuspid valve is narrowed or stiffened, it decreases the amount of blood that can flow through it. This decrease raises the pressure in the right atrium and causes the atrium to enlarge. It also causes the right ventricle to shrink, and lowers the cardiac output.

Causes and symptoms

Tricuspid valve stenosis is most often the result of rheumatic fever. On rare occasions, it is caused by a tumor or disease of the connective tissue. The rarest cause is a birth defect.

A person with tricuspid valve stenosis may experience generalized weakness and fatigue. Many people have palpitations and can feel fluttering in their neck. Over time, there may be pain in the upper right abdomen, due to increased congestion and enlargement of the liver.

Diagnosis

The noise produced by blood trying to flow through a stenotic valve can be heard with a stethoscope, and is referred to as a murmur. An x ray of the chest will show the right atrium to be enlarged. Further support for this diagnosis is found on an echocardiogram of the heart, which will show an image of the stenotic valve and measure its severity.

Treatment

Tricuspid valve stenosis itself usually doesn't require treatment. However, if there is damage to other valves in the heart as well, then surgical repair or replacement must be considered.

Since a person with known tricuspid valve stenosis is at risk for infections of the heart, antibiotics should be taken before and after oral or dental surgery, or urologic procedures.

Prognosis

Mild tricuspid valve stenosis is not usually considered cause for surgery. The decision to repair or replace the tricuspid valve is often based on the health of the aortic and mitral valves, rather than on the severity of stenosis in the tricuspid valve.

Prevention

Rheumatic fever, the usual cause of tricuspid valve stenosis, has almost disappeared in North America and western Europe. Therefore, the number of people who acquired this condition in childhood will decline over time.

Resources

ORGANIZATIONS

American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300 or (800) 242-8721. inquire@heart.org. 〈http://www.americanheart.org〉.

KEY TERMS

Rheumatic fever— An inflammatory illness that can follow strep throat, and could cause heart damage.