About Tricuspid Valve Disease

Tricuspid valve disease affects the valve between the right atrium and the right ventricle of the heart. The tricuspid valve normally allows blood to flow in one direction from the right atrium to the right ventricle. However, when the valve becomes diseased, this flow can be either restricted (tricuspid valve stenosis) or can leak backwards (tricuspid valve regurgitation).

Causes of Tricuspid Valve Disease

Several factors can lead to tricuspid valve disease, including:

• Infections such as rheumatic fever or infective endocarditis.
• Congenital defects like Ebstein’s anomaly.
• Pulmonary hypertension, which can cause the right ventricle to enlarge, leading to valve dysfunction.
• Conditions like carcinoid heart disease, systemic lupus erythematosus, and tumors.
• Use of certain medications, such as the diet drug fen-phen.

Symptoms of Tricuspid Valve Disease

Symptoms can vary widely and may include:

• Fatigue or general weakness.
• Shortness of breath (dyspnea).
• Swelling (oedema) in the legs, abdomen, or feet.
• Atrial fibrillation or other irregular heart rhythms.
• Pulsing or fluttering sensation in the neck.
• An enlarged liver, and sometimes cold or discoloured skin.

Diagnosis and Monitoring

Tricuspid valve disease is often detected during a physical exam when a doctor hears a heart murmur. Further diagnostic tests such as echocardiograms, chest X-rays, and possibly a cardiac MRI are used to confirm the diagnosis and assess severity. Regular monitoring is crucial, especially as the disease progresses.

Treatment Options

Treatment varies depending on the severity of the condition:

• Mild Cases: Often managed with regular monitoring and medications like diuretics to reduce fluid buildup, or anticoagulants if arrhythmias are present.
• Advanced Cases: May require surgical intervention. Options include:
  • Valve Repair: Preferable when feasible, this can involve procedures like patching holes, reconnecting valve leaflets, or reshaping the valve.
  • Valve Replacement: If repair is not possible, the valve may be replaced with either a biological (tissue) or mechanical valve. Each has its benefits, with tissue valves generally requiring replacement after 10-15 years and mechanical valves necessitating lifelong blood-thinning medication.

Recovery typically involves a hospital stay and a period of restricted activities. With successful treatment, patients often experience significant improvement in symptoms and overall quality of life.