What Is Tricuspid Valve Disease?

The tricuspid valve lies within the heart, separating the right atrium and ventricle. It allows forward blood flow and prevents backward flow through the right side of the heart. The tricuspid valve is referred to as a semilunar valve because it has three cusps that are shaped like half moons.

There are two main diseases or malfunctions of heart valves: regurgitation (valve does not close tightly) and stenosis (valve does not open fully). Regurgitation and stenosis disrupt the heart cycle because when the heart valves fail to open and close properly, there is improper blood flow through the heart.

Tricuspid valve disease is usually diagnosed when the valve becomes incompetent, and blood flows backward when it should be flowing forward to the lungs. This problem leads to failure of the right ventricle, which has to work harder to maintain forward flow. Symptoms may include swelling of the legs and/or abdominal swelling. Surgical or procedural repair of the tricuspid valve may be necessary for those with severe disease.

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Tricuspid valve stenosis

If you have tricuspid valve stenosis, your tricuspid valve opening does not open wide enough. That limits your heart's ability to pump blood because of the increased force required to pump blood through the stenotic (stiff) valve.

The main risk factor for tricuspid valve stenosis is exposure to streptococcal infection that is not diagnosed. Without early diagnosis and adequate treatment, the infection can lead to rheumatic fever, an inflammatory disease. It usually takes two or more years after having rheumatic fever for the thickened valve to develop. Most patients do not have symptoms for 15 to 20 years after an episode of rheumatic fever.

Tricuspid valve stenosis can be prevented with the adequate treatment of strep (Streptococcus) throat infections. Once you have tricuspid valve stenosis, you can prevent further progression of the disease by adequately treating recurrent episodes of rheumatic fever.

Tricuspid valve insufficiency/regurgitation

If you have tricuspid valve insufficiency/regurgitation, your tricuspid valve does not close completely, causing blood to flow backward instead of forward through the valve.

The most common cause of tricuspid valve insufficiency/regurgitation is dilatation (enlargement) of the right ventricle and of the annulus (space in the heart where the valve sits). On rare occasions, tricuspid valve insufficiency/regurgitation can be a symptom of another valve disease, such as tricuspid valve prolapse or a congenital deformity.

The risk factors for tricuspid valve insufficiency include pulmonary hypertension, undiagnosed streptococcal infection and certain valve diseases. Complications include endocarditis, an infection that affects the lining of the heart's chambers and the heart valves.