Tricuspid stenosis

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Tricuspid stenosis is a rare valvular abnormality resulting from the narrowing of the tricuspid valve orifice. As with all valvular heart diseases, echocardiography is key to making the diagnosis and assessing the severity.

Contents

Aetiology

  • Rheumatic heart disease (nearly all cases)
  • Carcinoid syndrome
  • Endocarditis
  • Systemic lupus erythematosus

Echocardiographic features

2D-Echocardiography

  • Thickening of valve leaflets
  • Calcification
  • restricted mobility
  • " Doming " of the leaflets

Doppler Echocardiography

  • Severity can be assessed by the transvalvular gradient
Using continuous wave doppler across the tricuspid valve in apical-4-chamber view. The peak gradient can be calculated using the modified Bernoulli equation.
Tricuspid valve area = ( annulus PW Vti * Cross sectional area of the annulus) / valve CW Vti

Assessment of severity with echocardiography

Severity of tricuspid stenosis
Severity mild moderate severe
Tricuspid valve area - - <1
Mean Pressure Gradient <4 4-7 >7

Differential diagnosis

  • Right atrial tumour
  • Right atrial ball valve thrombus
  • Large vegetations
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