Tricuspid and Pulmonic Valve Disease

Posted by e-Medical PPT Monday, November 19, 2012
Goals of Conference
Understand Tricuspid and Pulmonic valvestenosis and regurgitation
Diagnosis
Treatment options
Specific conditions
Ebstein anomaly
Carcinoid Syndrome

Right AtrialWaveform
a wave - RA contraction
elevated in RV failure
c wave - tricuspid closure
v wave - passive filling of RA during
ventricular systole = T wave on ECG
elevated in tricuspid regurgitation
x descent - atrial diastole
y descent - atrial emptying

Tricuspid Stenosis
Etiology
Almost always rheumatic
Other causes are rare
Congenital tricuspid atresia
Right atrial tumors
Carcinoid syndrome
More often tricuspid regurgitation
Endomyocardial fibrosis
Vegetations
Pacemaker lead
Extracardiac tumors

Rheumatic Tricuspid Stenosis
rheumatic heart disease
But clinically significant in only 5%
Isolated TS is rare
Almost always mitral valve involvement
Also aortic valve involvement common

Pathologic Findings
Rheumatic Tricuspid Stenosis
Similar to mitral stenosis
Fusion and shortening of chordae tendineae
Fusion of leaflet edges
Calcification is rare
Right atrial dilatation, wall thickening
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