What is Tricuspid Valve Regurgitation?
Tricuspid regurgitation is leakiness of the tricuspid valve. The tricuspid valve is valve between the upper and lower chambers of the right side of the heart. Everyone has heard of the valve between the upper and lower chambers of the left side of the heart, the mitral valve. The tricuspid valve has been described as the forgotten valve, simply because of how much attention the mitral valve gets! But over recent years the tricuspid valve and tricuspid regurgitation has received much more attention.
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Causes
In general tricuspid regurgitation can be thought of as primary or secondary. In primary tricuspid regurgitation the tricuspid valve leaflets or the chords that attach the valve to the heart pumping chambers themselves are affected. In secondary tricuspid regurgitation the leaflets and chords themselves are not primarily affected, rather there is a process called annular dilation. The annulus is the ring like structure in between the upper and lower chambers of the heart that houses the valve. When the annulus enlarges, it stretches the valve leaflets cannot meet together, so they can no longer act as a valve, and therefore blood leaks backward.
Several things can cause primary tricuspid regurgitation, where the leaflets and/or chords are affected. These include valve infection, traumatic causes, birth defects and damage from pacemaker leads amongst other causes. Secondary tricuspid regurgitation is caused by factors leading to annulus enlargement, such as right ventricular failure or enlargement, or severely elevated pressures in the right side of the heart such as pulmonary hypertension. Even though the tricuspid valve is a right-sided heart structure, the most common cause of tricuspid regurgitation is actually left sided heart failure leading to congestion and subsequent right-sided problems!
Signs And Symptoms
When tricuspid regurgitation is severe it can lead to right sided heart failure and right-sided congestion. The degree of symptoms generally depends on how badly the right side of the heart is failing. In addition to shortness of breath, there can be weakness, swelling, liver dysfunction, fatigue and weight loss. The swelling is typically in the legs and can also be in the stomach in the end stages. When the right side of the heart fails badly, it affects the left side too which can lead to shock. Its like a cycle whereby left heart failure, can lead to right heat failure, that can worsen left heart failure, and so on.
Diagnosis
Until tricuspid regurgitation becomes severe its not easy to diagnose by physical exam. There is a heart murmur, and also the jugular vein in the neck can often seen to be pulsating prominently with a characteristic pattern. The gold-standard way to diagnose tricuspid regurgitation is an echocardiogram, an ultrasound scan of the heart. This test is known as a TTE, short for transthoracic echocardiogram.
The TTE is useful in not only grading the severity of the leakiness of the tricuspid valve, but also provides important information regarding the right sided heart pressures and the pumping function of the right ventricle. The TTE will also tell us the cause of the tricuspid regurgitation. Severe tricuspid regurgitation is typically leakiness of more than 45ml per beat. This is supported by signs of right-sided heart failure such as enlargement of the pumping chamber, and decreased pump function. There may also be elevation of the pulmonary artery pressures leading to pulmonary hypertension.
Mild Tricuspid Regurgitation
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Moderate Tricuspid Regurgitation
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Severe Tricuspid Regurgitation
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Treatment
There are no medicines that will improve the tricuspid valve itself or that have been proven to improve the right ventricular enlargement or failure associated with tricuspid valve disease. The management of severe tricuspid regurgitation is discussed in the section about surgery. In mild to moderate regurgitation, and even severe, it is important to treat the underlying cause. In general this means treating the left sided heart failure to try and reduce the congestion. Diuretics such as Lasix (furosemide) are typically used to take off excess water and try and improve symptoms. When pressures in the right side of the heart and lungs are severely elevated then treatments to reduce those may be somewhat helpful in reducing symptoms. It’s also important to treat conditions that can prevent further development of heart failure such as high blood pressure, sleep apnea, and obesity.
When Is An Operation Needed For Tricuspid Valve Regurgitation?
For years the tricuspid valve was relatively ignored, however over recent years it has gained much more attention. It is now realized that in many circumstances, delaying an operation on a severely leaky mitral valve leads to worse outcomes. As we discussed above, there is primary and secondary tricuspid regurgitation. The goal of an operation for tricuspid regurgitation is to improve symptoms, and prevent progressive failure of the right ventricle, the hearts right-sided pumping chamber.
Surgery for Primary Tricuspid Regurgitation
Primary tricuspid regurgitation is where there is a direct problem with the valve leaflets or associated chord strings. This only accounts for around 20% of severe tricuspid regurgitation. The majority of tricuspid regurgitation is secondary and due to left sided heart disease. In the case of primary tricuspid regurgitation, the primary operation will be on the tricuspid valve, unlike secondary tricuspid regurgitation where operations will typically be done on the left sided heart valve (the mitral valve) also. Surgery is recommended for primary tricuspid regurgitation when there is development of symptoms, or evidence of progressive enlargement and failure of the right ventricle. In the past we used to wait until there were severe symptoms, however now the trend is to operate when there is development of mild symptoms in order to prevent irreversible heart damage.
Surgery for Secondary Tricuspid Regurgitation
Secondary tricuspid regurgitation is where the problem isn’t with the valve leaflets, but rather due to enlargement of the heart and the structures that hold the valve in place. This is mainly due to left sided heart failure or left sided valve problems that lead to congestion and put higher pressure on the right ventricle and the right-sided tricuspid valve. The majority of people that present with severe tricuspid regurgitation have secondary tricuspid regurgitation. It used to be thought that the best way to treat the tricuspid regurgitation was to fix the left sided heart valve, i.e. the mitral valve. The thinking was that this would then relieve pressure on the right side of the heart, and the tricuspid regurgitation would improve. Over the years we realized that it was in-fact very difficult to predict whether an operation on the left sided heart valves would improve the tricuspid regurgitation, and also that the tricuspid regurgitation, although it may improve initially, would often recur. Due to this, the contemporary approach to tricuspid regurgitation is more aggressive. In general, when patients present for left sided valve surgery, such as aortic or mitral valve surgery, if there is severe TR then the tricuspid valve should be operated on at the same time. Some specialists would advocate for an even more aggressive approach and when doing left sided valve surgery, will operate on the tricuspid valve if there are lesser degrees of tricuspid regurgitation, particularly if there is evidence of valve enlargement. The decision depends on many factors that include surgical risk and should be made on a case-by-case basis by specialists familiar with tricuspid valve disease. In our center we frequently use robotic heart surgery to fix the tricuspid valve.
Frequently Asked Questions about Tricuspid Valve Replacement
Tricuspid Valve Repair or Tricuspid Valve Replacement?
In general the tricuspid valve should be repaired, and not replaced. Tricuspid valve replacement should be avoided unless absolutely necessary and it is not possible to perform tricuspid valve repair, or a previous tricuspid valve repair has failed. The preferred operation for tricuspid valve regurgitation is valve repair, whereby the original valve is kept in place and techniques used to fix it. Most commonly this consists of placement of sutures or a ring around the tricuspid valve to reduce it back to normal size and restore normal valve competency.
My Echocardiogram Report Showed Trace Tricuspid Regurgitation – Should I be Worried?
Trace tricuspid regurgitation basically means that only a tiny bit of blood leaks back in to the upper right chamber of the heart. The simple answer to the question is no you should not be worried. In fact trace tricuspid regurgitation is considered a normal finding. Having trace tricuspid regurgitation is actually useful for the physicians performing and interpreting the test, as we use this to calculate the pulmonary artery pressure. No treatment and no specific follow up are required for trace tricuspid regurgitation.
My Echocardiogram Report Showed Mild Tricuspid Regurgitation – Should I be Worried?
In general, no, there is no cause for concern. Mild tricuspid regurgitation is common. It does not cause symptoms or have an effect on the heart function. As with anyone, it’s important to treat usual cardiac risk factors and prevent the development of heart failure. In general, no specific follow up is required for mild tricuspid regurgitation.
My Echocardiogram Report Showed Moderate Tricuspid Regurgitation – What Should Be Done?
Moderate tricuspid regurgitation is not typically associated with any signs or symptoms. Isolated tricuspid regurgitation does not require any valve intervention unless there is an operation needed on the left sided (aortic or mitral) valves. In the case of just moderate tricuspid regurgitation, it’s important to treat ongoing cardiac risk factors such as hypertension. In terms of follow up, repeat echocardiography may be performed after an interval, to the leakiness hasn’t progressed to severe, and also to monitor the heart size and function.
References
European society of cardiology guidelines – http://eurheartj.oxfordjournals.org/content/33/19/2451.long
ACC/AHA guidelines – http://www.ncbi.nlm.nih.gov/pubmed/24603191
Had rheumantic fever age 12 in 1952. Was misdiagnosed as mitral valve for years. Constant tachacardias attracts dizzy years of adema. Last yr full treatment diagnosis was TR regurgitation.. no mitral..it’s moderate.sometimes sharp pains night but edema STILL big problem.why not see up leak now before I get any older.I’m 75 now..if it goes to severe I may not survive a surgury that late in life. On 20mg ferosemide but asking cardiologist next month to double this. Am I doing everything right at this time? Am I too old at 75for valve leak sutures to close?
It all depends on your condition and risk of surgery. In suitable candidates we have performed tricuspid valve repair in patients even in to their 90’s. If its the cause of heart failure, severe in nature, causing enlargement and dysfunction of the right sided heart chambers then operative repair would be recommended in suitable candidates. Of course every patient needs to be assessed on a case by case basis.
Hi i was diagnosed with mild or moderate mitral valve regurgitation and mildoratrate tricuspid and trace of pulmonary valve leakage should I be worried ? Everything else think was fune and 60/65 ejection fration and only made it 7 minutes on the stress test
Debra. I was diagnosed with mild mitral regurgitation and listeriosis regurgitation should I be worried? What is the treatment of you have both?
Hi I am Michael from the small island of Barbados, I had an Echocardiogram done which revealed ( small,left ventricle with abnormal septal motion, possibly secondary to right bundle branch block, diffusely mild thickened,prolasping,trivially incompetent mitral valve and small left atrium,prolasping,mildly incompetent tricuspid valve and borderline dilated right atrium. Mildly thickened,hyperechoic, pericardium. I have not seen the cardiologist yet due to financial difficulties, can anyone give me their views on my results
You don’t have any currently significant valve issues. What does your EKG show and what is your ejection fraction on the echo.
to sir
we have congenital heart disease ( Tricuspid valve ) not close tightly leak blood
i have go to surgery and replace valve require not require please advice
Sir plz tell me some information aortic valve regurgitation mild & Tricuspid Regurgitation mild
plz suggest me both are same conditions Treatment?
Surgery?
No treatment needed, basically normal.
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I’m am 60 yrs and diagnosed with moderate tricuspid regurgitation with heart murmur. It seems dr says no big deal. Is there surgery for this?
Thank you
In general, moderate tricuspid regurgitation needs watching only or medical management as opposed to intervention.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
My echocardiogram findings were
Trace mitral regurgitation
And mild tricuspid regurgitation .. I’m 33 female. Should I be concerned? My anxiety is through the roof. Thank you
These are not concerning.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Really? You practically have to be in cardiac arrest before a repair can be made? I am having horrible edema mostlyaround abdoman and gain upwards of 8 pound in a day. Upped my ferosemide myself with no help. Finally told my son’s 25 mg hctc and within 20 minutes I started eliminating. This is a weekly problem. Can’t get my clothes on anymore. Isn’t this enough reason to ssee up my leaky valve? My no is always 116/66 so that’s not the problem. This awful water over abdomen legs hands is awful. Feel like the Pillsbury doughboy. Why is it so important to wait until your heart practically fails before surgery or have this horrible quality of life.even my chest has grown.oh in case you think I overeat..my calorie consumption is around 500-800 a day I eat just twice.as my stomach big enough with water..don’t need food on top of it. Am I a candidate or not and why?
Have you had a parenthesis to remove excess fluid in abdomen
Dr,my son is only 23 yrs old and in excutive check up, Echo is showing mild t TR and MR trivial. Can u tell me reason ? Is it reversible? He has obesity 82 kg weight.
These are relatively normal and not concerning findings.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I am 29 years of age i have rheumatoid artherites and have uveites i am on methotrexate. I had surgery a few days ago for a laproscopy for endometroses and cystoscopy. Surgery went well but after surgery i had chest pain and the pain was really bad i was on endone while in hospital. And they ran tests on me all good but the echocardiogram came back with sever tr. i have had the same test 4 years ago and came back clear. The hospital discharged me and told me to see the cardiologist. What does thsi mean severe tr
It means you have a severely leaky tricuspid valve, see the article above
I am 60 a female years ago told my Mitral valve and Tricuspid valve were regurtitating. Now I have chest pains,left side of my chest and neck feel like someone choking me pain down my left shoulder blade on my back. I need help!
You firstly need to seek urgent medical evaluation with those symptoms.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I am a 30 year old woman in 2003 I had a mitral valve replacement with a bovine valve that’s only leaking mild to moderately it’s very well after over 13 years I was having so much pain and pressure on my chest and in my neck I thought my mitral valve was going so I finally pushed and pushed and got my cardiologist to do a thing where they put you to sleep and put a camera down my throat. When I awoke the doctor told me to wait for my mom to come back in which was weird. But then she said what they found out that my tricuspid valve is leaking severely this summer I had my pacemaker removed because it has bacteria on it from my teeth, teeth can be very dangerous so I let everybody know to be very careful. I’m waiting now they made a call to Boston so I can have a surgical consult I’m in a lot of pain but as long as I don’t move or get excited or get upset it’s only pressure on my heart but II I do anything like a small is going to the bathroom or trying to brush my teeth or get dressed or look for the remote my heart starts pounding there’s a very large murmur. I was really scared the other day cuz it for about 24 hours it was extreme pain my heart started pounding out of my chest a few times and then it just stopped I thought I was I was passing away it was so scary. Please let these doctors get back to me soon I can’t wait any longer.
What is the meaning of “trivial to mild central mitral and tanscupid regurgitation” is it trivial and on the verge of being mild, or just trivial? Confused.
Just trivial, basically normal finding.
I had broken hip ball in left hip in 2014. Then for a whole year I had a sever case of staff infection. They had to remove all of hip stuff until infection was gone. Then another surgery to replace whol hip. Had ti hsve cadaver bones to help repair. I just started walking a few weeks ago with no cane ir walker. Now I have found out this week I have sluggish veins and blood vessels in my left calf leg. Sometimesy heart hurts. I also have mitro tricuspid regurgataion. Have had this since 1996. Could all this be my leg problems?
It depends if the tricuspid regurgitation is severe
I have normal ventricular systolie function 55% left atrial enlargement mild to moderate tricusipid valve regurgitation adnormal diastolic dysfunction what blood test can I ask for to see if I have an viral or infection in my heart I had a port in my subclavin and it got badly infection and ever since then I have had simple problems but because of my age 78 the docs don’t listen or say medicare won’t pay for it I am in my right mind and a psy nurse but they thing I don’t know how I feel I have lost weight and was
Walk 3times a week and have had heart palpations and feeling tired can you answer me?
Usually blood cultures are performed.
Can my three year old have her tonsils and adnoids removed even though she showed trace trace tricuspid regurgitation on her ECG? The doc cleared herbut I am juststill nervous. Thanks.
Its basically a normal finding and i wouldn’t worry
I had endocarditis 2 months ago and loves lived through treatment. Now they told me I have a small tear in the lower right ventrical of my heart. What does that actually mean?
Hi when you basically normal findings is because it’s depending on why they are leaky? All my valves are trace regurgitation but they also seem right ventricle mildly dilated and I have ppvr. I’m very fatigued, chest pains, shortness of breathe, and short winded fast when active…even walking up stairs. My feet and hands and stomach are also swollen 90 percent of the time. Should I be worried?
The valve findings themselves are not concerning. The symptoms are and would warrant evaluation. As for the right ventricle, i would start by having someone review the study then comment on the true nature of any abnormality.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I just had my mitral valve repaired a month ago. Before surgery they saw through echocardiogram that my tricuspid valve is leaking minimally but during surgery they checked it and decided that there is nothing wrong with it and didn’t repair it.
Now I still have a slight murmur and the tricuspid is still leaking minimally. I’m worried that I will need another surgery in the future just because they chose not to repair the tricuspid valve.
How likely is that a minimally leaking tricuspid valve, who looks anatomically fine as the surgeon says, will progress to severe? Can it correct itself now? Was it wise not to touch it although I already went through an operation on my mitral valve?
If you had mild tricuspid regurgitation there was no indication to repair it at the time of mitral valve surgery and i would not worry at all. Its not likely to progress if all else stays well. The murmur you have is not from the tricuspid regurgitation.
I was recently told I have mild mitral valve regurgitation and moderate tricuspid regurgitation. I have had symptoms such as a weird feeling in my neck, pounding pulse, fatigue, lower leg weakness, tingling and stomach bloating.These all come in “episodes.” BP elevates during episodes and I feel short of breath. Was told prob not related to the regurgitation, but I am concerned. Should I be worried about either regurgitation? Otherwise I’m a healthy 39 yr old with just a history of hypothyroidsm.
The symptoms you are describing are almost certainly not related to the valve disease, i would worry about that level of regurgitation.
My 2 year older daughter requires hearing aid in one ear. Her doctor suggested to also have her heart tested once as children with hearing problem can develop some heart complications. So, went to a cardiologist who did EC tests along with other tests. He diagnosed her with tricuspid Regurgitation. He didn’t mention if it was mild or moderate. Test didn’t find any dysfunctions in her heart and doctor only suggested regular checkups. No medicine is needed nor any changes in lifestyle.
Here are test results of blood flow in m/sec
Mitralis: 1.0
Tricuspidalis: 0.7
PulmonalKlappe: 1.4
Aorta ascendens: 1.0
Aorta descendens: 1.1
Could you please specify if this is considered mild or moderate tricuspid Regurgitation? Is there anything to worry about? Can this get worse over time?
Thank you
Its not possible to tell from those numbers, what did the echo report say regarding the severity of the regurgitation?
I was told by my Internist that I had a heart attack by way of the EKG findings. However, I went to to Mayo Clinic for several cardiology testings and it showed Tricuspid regurgitation. I told my cardiologist at Mayo Clinic that I had taken Cabergoline for a pituitary microadenoma for over 20 years and experienced swelling of the legs&ankles, swollen abdomen, and severe fatigue, but was only prescribed diuretics. Currently my heart is beating irregular and the swelling of the ankles and abdomen will not go down without the diuretics.
Honestly, I’m fearful that it’s more going on with my heart, but the cardiologist doesn’t appear to be concerned. I left message for the nurse to inform the cardiologist that I found the diagnosis from the results and to reiterate the years taking cabergoline as well, because I believe the Dr. was just in a rush while reading the report and looked over the findings on the tests.
Please advice if I should see another cardiologist.
Thank you Dr. Mustafa!
What does the echo report show exactly?
Tricuspid valve regurgitation moderate why wait till it gets severe
Because then the treatment would potentially be more risky than the disease.
Is it posdible for the valve to leak mild for ever without getin server ?
Yes
Had and echo done. Results
-Mitral Valve The leaflets are mildly thickened. The posterior leaflet is mildly prolapsed. There is mild
regurgitation. There is no evidence of mitral valve stenosis.
-Tricuspid valve structure is normal. There is mild to moderate regurgitation. There is no
evidence of tricuspid valve stenosis. The right ventricular systolic pressure is normal. The RVSP
is estimated at 26 mmHg.
There is trace pulmonic valve regurgitation. There is no evidence of pulmonic valve stenosis.
What can b done if the condition is severe???
Surgery is an option for appropriate candidates with severe tricuspid regurgitation if it is felt they would benefit from surgery.
Is there any relation between severe TR and chronic pulmonary trombo embolism? N Wat are the chance of success in case of surgery????
Severe TR along with severe PAH and chronic pulmonary trombo embolism is the diagnosis as per ECO report…what can be the next treatment step plz m desperate as the patient is my dad….
And is there any symptomatic treatment for temporary relief before other steps begin as fatigue Ness is very high n the cough is too severe???
I understand that trivial or trace as indicated above for tricuspid regurgitation is not significant, in the other hand mitral regurgitation might be the cause for tricuspid disease. Also, the mild mitral is not significant as well?? This is annoying because in one case we see the same condition of both valves tricuspid and mitral??
I mean as in normal life a trace of different bad things make the instrument junk?
Is this applicable for the heart as well.
You have nothing to worry about.
Have mitral and tricuspid regurgitation. Experiencing significant symptoms (shortness of breath, fatigue, tightness in chest, cheslike pain). Came on suddenly. First checked for blood clot in my lung. Determined that i regurgitation. At what point, do you resort to surgery. Healthy other than this.
How bad is the regurgitation? What does your echo show?
Hello, within the past year I have had 2 right shoulder scopes, 1 right hip scope, bilateral pulmonary emboli, DVT. I am in a preoperative status for my right knee and left hip. I have complained of multiple episodes of severe chest pain, palpitations and rapid heart rate. I have described symptoms to my cardiologist that resemble tachycardia arythmia. I just completed a pulmonary function test and received a diagnosis of mildly restrictive lungs. I just recently experienced a sudden chest pain that was accompanied by headaches only on the left side of my head. The chest pain is still very prominent and can get quite painful. I had an echo of the heart done and it shows trivial mitral regurgitation, trace/mild pulmonary regurgitation, trace tricuspid valve regurgitation, and trivial sized pericardial effusion. I know all these heart things are trivial but I do have pretty significant arythmia associated with exercise and constant presence of mild to severe chest pain. I am a 25yo male. Should I be concerned of my heart issues?
I recommend you get evaluated by a cardiologist for sure. Your echo however is relatively normal.
Thank you, my below comment is a repost but it does have some additional information that I forgot to put in this comment if you wouldn’t mind skimming over it. I have an appointment for the cardiologist in 3 weeks, I was just trying to get some insight since my appointment is so far away.
You should not be worried by these echo findings. They are reassuringly benign.
Hello, I am a 25yo male and within the past year I have had two shoulder scope surgeries, one right hip surgery, and a back radio frequency ablation. I am curently in a preoperative status for my right knee and left hip right. I developed bilateral pulmonary emboli and a DVT after my right hip surgery. I got an echo done in July. Then two weeks ago I was having abnormal chest pains on the left side of my chest, it was constantly dull and would have sharp spikes in pain. It shot like a “pulsating pain” up the left side of my chest, then neck. I then developed a severe headache on only the left side of my head. My BP is high during theses headaches and chest pain, i.e. 145/107 or 166/95. I did a pulmonary function test and the diagnosis was mildly restrictive lungs. I just got the echo results and it states I have trivial mitral regurgitation, trace/mild pulmonic regurgitation, trace tricuspid regurgitation, and trivial sized pericardial effusion. By this article, I should not me worried because they are trivial but should I be worried given my history? Or that I have so many “trivial” circumstances? Thanks in advance!
^adding to the above comment, I have been complaining on overall chest pain and heart palpitations for a while now. When I saw the cardiologist, she said the symptoms I was describing sounding like tachycardia arythmia. I have significant symptoms/episodes during exercise and mild symptoms a few times a day. I still have yet to be officially diagnosed on this matter. Thanks again.
Sorry for the duplicate comment, my earlier one disappeared so I reposted.
I’m not a doctor, just a daughter of a mother who watched and helped her mother through a very difficult time before nearly expiring due to Prinzmetal Angina… but luckily her disease was captured on an EKG whilst enroute to the hospital, her 7th ambulance ride in a month and a half. Research vasospasms and variant angina. These diseases are difficult for doctors to catch as they can only been seen when the attacks occur, making it challenging to get a diagnosis. When these events occur, your body will not produce the typical enzymes seen during a heart attack, nor will the doctors see damage to your heart. Additionally, if you have any habits such as smoking or drink copious amounts of coffee, you should stop these now. These are stimulates and can enduce an episode and/or trigger the disease (drug enduce vs. congenital) in an otherwise healthy individual. Best of luck to you.
My son is 17 years old and in great shape he is 6’5″ 255lbs he has been experiencing dizziness extreme fatigue, blurred vision during football practice took him to a cardiologist and they told us his right atrial is enlarged, moderate to severe pulmonic regurgitation, mild tricuspid regurgitation present, mild pulmonary hypertension. His cardiologist released him to play football should i get a second opinion? The doctor told my son to listen to his body and when he gets the symptoms to take a break.
Those are not normal findings. A lot depends on the effect on the heart, the size of the right ventricle etc. Moderate pulmonary regurgitation is relatively well tolerated. Given the presence of coexistent pulmonary HTN in a 17 year old, right heart catheterization should be a consideration. I would consider another opinion from a structural heart specialist / pediatric cardiologist if it would make you more comfortable.
How has your son been after this and what was done. Thanks billy.
I m a 40 year old female who had an echo done in 2010 and the results showed
Trace MR and TR
Normal left and right ventricular size,function, and thickness.
Should I be worried about heart failure because I am runner, which I run 1/2 and marathons alot.
Slight symptoms of dizziness and heart flutter occasionally, diagnosed with heart murmur in my early 30’s.
The echo report is essentially normal and of no concern whatsoever.
Trace TR is normal, no restrictions to exercise from that.
I just had an echo report. Showing mild aortic regurgitation, mild tricuspid regurgitation, mild mitral regurgitation. Not showing enlargement of left atrium but having symptoms of severe fatigue, dizzy spells, passed out twice this year, dull chest pain 24/7 but not severe pain just aches. Pulmonary valve is not leaking. But I’ve noticed I am short of breath all the time occasional swelling in ankles but not a lot. I am also having headaches and palpitations once in a while. But I was also just diagnosed with enlarged ventricles in brain and migraines that they think is causing seizures and cerebellar dysplasia. Don’t know all the neuro stuff yet. Appts. for neuro just made. All of this was found because I came in with TIA. Trying to find out if this could be related and should I be worried with my symptoms and with all 3 valves leaking although mild and quality of life is just not good if I will possibly need valve surgery. I am too tired to do daily functions.
The valves are almost certainly not related to the symptoms. Your valve disease is mild and in all likelihood will not progress to the point of having to need surgery. I would recommend concentrating the efforts on looking at other causes for the symptoms. With the TIA, causes including silent irregular heart beat should be considered if other causes are ruled out.
I just returned from the hospital after having an Echo. Aortic, mitral, and pulmonary valves had trivial regurgitation, which as I understand it, is normal. The confusion I’m having regards the tricuspid valve. Instead of specifying the degree of regurgitation, the report says, “Tricuspid valve is not well defined. Unable to estimate right ventricular systolic pressure due to an incomplete tricuspid regurgitation jet.” What does this mean in terms of valvular disease, and is this something to be concerned about?
I should mention that I had a heart attack 8 years ago (when I was 44), while the cardiologist was implanting 5 stents in the arteries around my heart. Since that time, I have done relatively well until my last annual cardiology exam. I had an abnormal EKG that showed I had had a recent heart attack, but the doctors couldn’t specify when, exactly, the heart attack occurred. That’s the reason my cardiologist ordered the Echocardiogram. Second question: is it possible to have a heart attack and not even know it?
The reason they look for the tricuspid valve and regurgitation is to estimate the pressure in the lung artery. In your case, as with many studies, this couldn’t be done as it couldn’t be seen well, it doesn’t necessarily mean anything bad and unless you have been told otherwise i wouldn’t worry too much. Do seek clarification next time you see a heart doctor. Yes it is possible to have silent heart attacks, although that would be unusual.
Hi sir,
My father faced heart attack in August doctor placed 2 stunts before discharge from hospital echo report is lvef 50percentage and mild tr, 2days back we visited the hospital again they did echo now lvef45 percentage, trivial td, mild Mr, I am really bothering about this we are using medication as per suggestion.
It is severe or normal please explain.
My recent echo showed moderate tricuspid regurgitation with PA pressure of 35.I have RA,have been treated for hypertension for ten yrs with Cozaar & Lopressor (well controlled).What is your opinion as to how to proceed? Do I have pulmonary hypertension? I am 62 yo female,not overweight.Thank you.
If that is accurate you don’t appear to have significant pulmonary hypertension, its typically >40 that is considered pulmonary hypertension.
I am a 46 year old female. I have congenital valve disease. Pulmonary stenosis and a bicuspid aorta. 20 years ago I had balloon valvuloplasty to my pulmonary valve. My pulmonary HTN was around 80 at that point. I recently had symptoms of palpitations with a feeling that I couldn’t breathe and was choking. These have subsided. However my doctor said my murmur changed, so he did an echo and referred me to a cardiologist. I was told that my tricuspid is moderately leaky. Last echo 5 years ago the tricuspid was normal. My pulmonary HTN is 51 now. It was recommended that I repeat the echo in a year and go for for probable cardiac cath and have the tricuspid replaced. I guess my questions are 1) did the abnormal pressures from my pulmonary valve cause this? 2) why wait? I now have lividoid vasculitis also. Is this associated with my heart?
Mary to be honest i would have to see your records and take a full history and review to give to accurate information. I think it would be wrong to give you generic answers that are not case specific. What i can tell you is that operation for moderate tricuspid regurgitation is rarely ever warranted in isolation. The first step in your work up is to rule out the recurrence of pulmonic stenosis, the right heart cath sounds a reasonable step to rule that out and also accurately assess any degree of pulmonary hypertension. Vasculitis can contribute to development of pulmonary hypertension and should be treated appropriately also.
Thank you for your quick response. To be honest, I wish I had asked more questions. I was shocked, and thought the cardiologist misspoke. I recently saw my rheumatologist and he has done blood work. He says I have something similar to lupus but will likely never have a specific diagnosis. He wants me to consider starting plaquenil. I also take aspirin 325 for the vasculitis. Waiting is just eating at me. I am so happy in my life and marriage now and and not knowing what the future holds is such a stressor. I will speak more about it with my internist at my next check up. I never expected this. I knew at some point possibly pulmonary and/or aortic valve would need to be replaced. I was hoping not for a while. To hear a 3rd valve is damaged leaves me wondering what my future holds.
I understand what you are telling me. When you say the operation for tricuspid is rarely warranted in isolation, meaning the pulmonary stenosis would likely be repaired at the same time. Which is what I suspected. My internist said he would find me the right cardiologists to treat this. I have faith that he will. Hopefully avoiding a situation where things become urgent rather quickly like the last time and I am thrown into a situation where a doctor I have never met before is suddenly performing heart surgery on me. That scares me the most.
Hi Mary
I am 42 years old and two years ago my legs and feet got so swollen and painful it was hard to walk. My dad had lupus and I thought that is what I had. My doctor did bloodwork and it came back with positive ANA so he referred to rheumatologist for further testing. He did bloodwork and sent to a lab in California which is apparently the only lab that test for cause of positive ANA. I was diagnosed with scleroderma. I started taking Plaquenil about a year ago because my symptoms were getting worse. Since I started taking it I have not experienced any new symptoms or progression of existing ones so, for me it has been beneficial.
I’m 45 I have been having irregular heart beats where my heart will start beating faster for no reason and then slow back to normal after 15min or so. They did and echo and discovered my ejection fraction was 40. So they put me on cardival. It helped my ejection fraction go up to 46 but it’s still low. The newest echo showed trace mitral regurgitation and trace tricuspid regurgitation is this something to be conserend about. Also my mom and my aunt have both had to have there mitral valve replaced is this something that is hereditary?
There may be a hereditary component but it is not proven to be a strong risk factor. Your regurgitation is minimal and of no significance.
I was DX with mild leakage in all four valves in 2006 along with mild PH. I got a another Echo in 2009 which showed the same, except the PH median went up. Now its 2016, I have been dealing with an array of issues, fatigue, swelling, loss of breath even laying down, pain in my neck when I do even light work outs, feeling faint, and even passing out when getting out of a hot shower recently. cardiologist did a stress test, which was “pretty normal” his words-
I am also getting another Echo in December.
I guess my question is, if I got my valve fixed, would the PH go away, or at least lessen in severity?
I cant imagine living the rest of my life feeling this way, I’m only 28, and I literally feel like death may be better.
Doctor said he wont operate unless the regurg is severe even though im symptomatic, so I just don’t know what to do next.
should add, PH level in 2006 was 43, and in 2006 was 54.
The mild regurgitation is absolutely not related to your symptoms. No-one should even entertain repairing a mildly leaky valve.
I was DX with mild leakage in all four valves in 2006 along with mild PH. I got a another Echo in 2009 which showed the same, except the PH median went up. Now its 2016, I have been dealing with an array of issues, fatigue, swelling, loss of breath even laying down, pain in my neck when I do even light work outs, feeling faint, and even passing out when getting out of a hot shower recently. cardiologist did a stress test, which was “pretty normal” his words-
I am also getting another Echo in December.
I guess my question is, if I got my valve fixed, would the PH go away, or at least lessen in severity?
I cant imagine living the rest of my life feeling this way, I’m only 28, and I literally feel like death may be better.
Doctor said he wont operate unless the regurg is severe even though im symptomatic, so I just don’t know what to do next.
should add- in 2006 PH was at 43 and in 2006 54
See the previous answer, let me know if further questions.
Hello, same Mary as above with the pulmonary stenosis and leaky tricuspid. Hoping you could answer another question for me. I saw a cardiologist in a large group in a large hospital yesterday. I need more testing, but it is likely I will need pulmonary and tricuspid valve replacement. Also testing on vasculitis. Once testing is done the group will review my case and decide who is best to treat me. I was told it would be open heart, as there is nobody in the area has experience with replacing these valves via cathedor. I have a complicated medical history. I am curious about the risks with both procedures. Wondering if looking outside the area for treatment may be a better option. My history includes noonan syndrom, vasculitis, diabetes, and thyroid cancer. Is there a benefit to having open heart vs cathedor?
See if you can get hold of the full echo report so i can review it.
I will. I saw him at a satellite location at a small hospital. I am going for new TTE next week at the main location because equipment is better. He says he can then request authorization from insurance for a TEE. Once these things are in place I will get those reports. Thank you.
Iam 50yrs. Old female over weight, obesity, high blood pressure was diagnosed with mild tricuspid valve regurgitation/mild mitral valve regurgitation on 11/14/16 and the day they told me my blood pressure was 186/95 and I have chest pain on my left side that moves under my left arm pit my upper sides hurt like they are squeezing them ,shortness of breath should I be concerned and what can I expect happening to me in the future. Please advise me p.s I have already been working on my weight I was 312 now as of 11/19/16 iam 277 but still having pain and very tired also have OSA they said I stop breathing 51 times in one hour
I can tell you that your tricuspid valve and mitral valve disease is not of any concern. You are doing a good thing in trying to reduce your weight. If you have OSA you should be using CPAP at night, it will reduce your cardiovascular risk and make you feel better.
I was told I have tricuspid regurgitation and to have an echo every 8 months. My heart skips every 3 beats now. I can’t bend my arms very long or my hands go numb. I have severe anxiety I think its BC of my heart. Is it possible for this to cause anxiety? I have swelling in my abdomen and fatigue. I’ve gone to the hospital BC of my anxiety level and my blood pressure gets high at times 180/110.. I’m only 30 the doc said I was most likely born with the tricuspid regurgitation. I don’t know how severe but I just had my echo done so I’ll get results and ask my next appointment. But is it possible to cause anxiety?
The anxiety has nothing to do with the tricuspid regurgitation. Can you provide details of how bad the tricuspid regurgitation is? I wonder if the palpitations being so frequent are causing anxiety. I would suggest a monitor to characterize the palpitations to see if they can be treated.
I have anxiety and the doc said she heard an extra beat so sent me for echo they called to tell me I had trace regurgitation but didn’t tell me where or what valve told me they would send me too cardiologist.. of course it has made my anxiety worse ..can that make the regurg worsen should I be worried? I am 43
You should not at all be worried about trace tricuspid regurgitation, its considered a normal finding.
Doc
My mother is 61/obese/hypertensive/diabetic/hypothyroid/ under medications for all above.recently she felt breathless pain in chest left side n weakness.cannot perform her daily routine work.Ecg shows poor R wave progression. Chest x ray shows mild cardiomegaly with congested lungs. Echo shows severe pulmonary systolic hypertension. Tricuspid regurgitation is 3+.what should be the line of treatment.what should i worry about.
Waiting for your quick response.
Saurabh.
The issue here is not the tricuspid regurgitation, rather it is the level of pulmonary hypertension. If it is severe then underlying potential causes need to be investigated. If severe, then a right heart catheterization may be an appropriate next step to assess the pulmonary pressure and also the treatment options.
I’m 35 years old, and have a pacemaker (dual chamber). In May an echo showed a normal right side heart but a grade 2 tricuspid regurgitation. At the end of October I had an echo and it showed a grade 3/4 tricuspid regurgitation and a very dilated right atrium and a dilated right ventricle (51 mm) rest of the heart looks ok, and the function of both right and left side of the heart are acceptable. I have symptoms of fatigue, pain in upper abdomen, shortness of breath, decreased exercise tolerance, swollen abdomen, palpitations. My doctor is a bit indecisive about the whole situation, but my biggest fear is getting irreversible heart damage leading to heart failure. My feeling is that we should fix the tricuspid as soon as possible, what is your take on this?
Do you have more details of the echo report. Has the mechanism of the tricuspid regurgitation been determined? Is it possibly related to the pacemaker or is it leaflet pathology? these important questions need to be addressed. Also a right heart catheterization should be considered to gather more information.
Hello Doctor,
I have an echo scheduled for next weebut I’d like your opinion. You seem more than knowledgeable. I had IE both 10 years ago and 6 years ago. Six years ago my tricuspid valve was repaired and a congenital septal defect was also repaired. I have yearly echos and take propranolol daily. The last echo I had, approx 8 months ago, showed “moderate-severe tricuspid valve regurgitation”. Watchful waiting continued. In last few weeks however, I’ve had a few episodes of chest pain, radiating to under armpit, neck and down arm, shortness of breath all the time, fatigue, headaches and the feeling of pulsating in my upper chest area. My ankles are a little swollen, more so the right and I lost 40 lbs without trying in about 9 months. Then over the last couple weeks I’ve gained a good ten back. I’m of a healthy weight. I went to ER and my EKG was normal. My quality of life isn’t great roght now and I’m only 36. My cardiologist said last time I saw her that if it got worse, it would need to be repaired. I’ve had no fevers. My Monocytes and leukeocytes are very slightly elevated. My troponin and other usual chemistries are normal. Any thoughts on whether all of this is related? Anything I should be aware of? I know you are busy however, a response would be greatly appreciated, as I am worried and confused. Thank you.
This is a complex case and in honestly id have to see your full case details and take your full history to comment appropriately. Do you have details of the last few echo reports, what is the function of your right ventricle and the size, have these changed over time? It also sounds like you need a right heart catheterization to gather further information.
Hello again,
I tried to get you some more specific information.
2013 Echo:
I don’t have a copy of echo report from 2013 but the notes say, “normal right ventricular size”, “severely enlarged right atrial chamber size”, “mild TR reported “, “RV mild”, “RV chamber was of normal size”, “well preserved left ventricular function. ”
5/2016 Echo:
Normal left ventricular systolic function.
Normal right ventricular size.
Normal right ventricular systolic function.
Moderate to severe Tricuspid regurgitation by Doppler.
Doppler findings do not support pulmonary hypertension
PA systolic pressure estimate = 25mmHg.
A normal IVC diameter which collapses greater than 50% would support an
normal RA pressure of 3 mmHg (range 0-5mmHg).
Left Ventricle (LV) Final
Normal left ventricular size.
Normal LV wall thickness
Normal left ventricular systolic function.
Normal left ventricular wall motion
Right Ventricle (RV) Final
Normal right ventricular size.
Normal right ventricular systolic function.
Left and Right Atria (LA, RA) Final
Normal LA chamber size.
Severely enlarged right atrial chamber size
Mitral Valve (MV) Final
Normal mitral valve leaflet morphology
Tricuspid Valve (TV) Final
Normal tricuspid valve morphology
Doppler findings do not support pulmonary hypertension
Moderate to severe Tricuspid regurgitation by Doppler.
PA systolic pressure estimate = 25mmHg.
Aortic Valve (AoV) Final
Trileaflet Aortic valve.
The aortic valve leaflet mobility appears normal
Pulmonic Valve (PV) Final
The pulmonic valve leaflets are poorly seen.
No pulmonic valve stenosis by doppler
Trace pulmonic valve insufficiency by doppler.
Aorta and Pulmonary Artery (Ao, PA) Final
The aortic root is normal size.
Moderate pulmonary artery dilation.
Pericardium/Pleura Final
There is no pericardial effusion.
No pleural effusion
Inf. Vena Cava (IVC) / Pulm. Veins Final
A normal IVC diameter which collapses greater than 50% would support an normal
RA pressure of 3 mmHg (range 0-5mmHg).
Procedures Final
IRL Limited 2D (81393308)
IRL Color Flow (81393325)
IRL Limited Doppler (81393321)
IRL Complete 2D with Doppler, Color Flow and image documentation (81393306)
I personally viewed the echocardiogram and approve the above interpretation
Primary ICD-9 Code
Obviously my condition has gotten worse between 3012 and 2016. I know my body and feel its gotten even worse recently. My cardiologist’s notes from 2016 echo say to do more watchful waiting and wont consider surgery unless I have pulmonary hypertension. From my research, and I’m no doctor, just a scared patient that wants to feel some control in a situation that truly is out of everyone’s hands and I was under the impression that a reoperation before serious complications arise is safer. I just know something has changed and I’m exhausted all the time and having pains under my ribs on the bottom. I’m scheduled to see her and get another echo on Wednesday but your opinion, would be so helpful for me. Thank you so much for taking the time to read this novel of a post.
It doesn’t make sense and to be honest without evaluating you in the office its difficult to comment responsibly. Lets see what the new echo shows. Importantly your right sided chambers appear to be normal size, but these images need to be reviewed closely by someone comfortable to evaluate tricuspid valve disease. Intervention on tricuspid valve disease differs greatly on a case by case basis, in our center we predominantly use a robotic approach to repair when indicated.. The first issue here is to decide whether the TR is actually severe or not and whether the right heart is significantly enlarged or not. Good news for you is that in the setting of a normal RV, the pulmonary artery pressure is reassuringly normal.
This same Mary as above. My cardiologists office called me with echo results. They are very different from my echo less than 4 months ago. I don’t think it will be necessary to have you review it. My pulmonary valve on this one looks only mildly stenotic. There is now some concern with the aortic valve as it is moderately stenotic. He is having me come in to discuss this with me in a couple days. I am very confused how this can be so different. 3 months ago my aortic valve was minimally stenotic at 2.9cm. Now it’s half that. I honestly don’t believe it could have progressed that quickly and there must have been an error. I assume this could be the cause of the leaky tricuspid and the pulmonary HTN? I assume at this point no surgery will be recommended. To be honest, I went 10 years without seeing a cardiologist, the things I was told kept me awake at night. At least 10 occasions from childhood being told surgery was needed. True once. Being told to go on permanent disability more than once due to my weak heart. I refused, I enjoy working. A near fatal event during my hospitalization for valve repair, leaving the hospital on more medication than I went in on. Those medications caused sinus pauses, after routine Holter monitor he sent sheriff’s to my house to do a welfare check, assuming I died in my sleep because he couldn’t reach me. I think my body will tell me when it’s time to see a cardiologist again. I need a break.
Could you please recommend an interventional cardiologist in the Phoenix, Arizona area?
My daughter had a few fainting episodes when she was 12. She had a 2DEcho to r/o elongated QT syndrome. All was ruled out. They attributed her fainting to puberty. She is now 19 and away at college. She is complaining of a distended left neck vein (Y-shaped). Its soft, she feels a slight pulse.No SOB, dizziness or chest pain. Occasional intermittent left neck achiness. Has an appt on Dec 19 when gets home from school. Should I be worried until then?
In terms of the symptoms themselves i would suggest she is seen by a Dr to ensure no concern. In terms of the valves themselves i strongly doubt there is an emergent issue, distended neck veins can be common and then pain is not related to any potential heart valve issue.
I’ve had two AVR in past six years and pericardial tamponade. I now have moderate level of mitral and tricuspid regurgitation. Would surgery be in the future?
Not necessarily, but it will need following closely.
Hi there. I’m a 35 year old female. I also have POTS. I just met with my cardiologist with results of an echocardiogram I had for shoulder blade pain that he believes is acid reflux related. My ejection fraction was 50. He said I had moderate tricuspid regurgitation in between 2-3, mild pulmonary hypertension at 42 (he said normal was 25-35, and a mildly enlarged right atrium. Everything else was normal. He’s not concerned at all about this, told me not to worry and said I just needed to come back in 2-3 years to repeat it. He said multiple things can affect this and tomorrow another echo could be normal. It changes due to fluid status, etc. After reading on the internet I’m having major anxiety about this. I have two kids and I’m so worried. What is your opinion on these results? Thank you!
There is nothing emergently concerning about your echo and i don’t think you need to be anxious. In general moderate TR would be followed over time as would mild pulmonary hypertension.
Thank you. To follow up with my last comment, I had my stress test and came back normal. My doctor said since I’m having so much anxiety about my rvsp number of 42, that I should just do a right heart cath to see what the real pressures are. He said he wouldn’t do it if it were him, but he thinks I will lose sleep over it for the next year. Do you agree with this based on my echo? Do my numbers warrant an invasive procedure?
Also can moderate triscuspid regurgitation of 2 to 3 cause a mildy enlarged atrium?
How likely is it that I truly have pulmonary hypertension based on my echo? He thinks it’s very unlikely.
Thank you!
Hello dr mustafa my mum who is 79 years old has been diagnosed with heart failure has severe tr shortness of breath leg swelling this came on suddenly she had a heart valve fitted in 1998 she has had an scan wich says the following ..
blood pressure 150/58 irregular heart sounds between 60-70 bpm mild leg oedema
..echocardiogram shows normal left ventricular size and function with good ventricular systolic function and mild concentric left ventricular hypertrophy.
The right ventricle is enlarged the right ventricular systolic function is normal their is a marked biatrial enlargement their is a normally functioning mechanical aortic prosthetic valve with 2 small washing jets of aortic regurgitation mild mitral regurgitation is present . Their is severe tricuspid regurgitation and lack of coaption of the tricuspid valve leaflets . The right ventricular systolic function is elevated . They concluded that the underlying mechanism of tricuspid regurgitation is likely diastolic dysfunction and want to introduce spironolactone 12.6 mg once a day monitoring her u and e,s follow up on 6 months our question is can my mum have an operation on the leaking tricuspid valve she has shortness of breath and legs swell up very quickly obviously she is also very worried we believe in God and what is gods will will be she is a fairly fit and active lady before this came on and woud go ahead with surgery but the dr seemed to talk her out of this saying they will try to control it with water tablets my mum feel she still has a lot of life left in her and is willing to go ahead with an op your opinions woud be very much appreciated god bless
Timing of surgery and selection of candidates for tricuspid surgery needs to be paid very careful attention to. In out tricuspid program we involve the valve team, the surgeon, the pulmonolologist and other specialists as needed. We prefer a robotic approach where possible.
Thank you dr Ahmed for reply god bless you x
I was diagnosed with a tumor on the right side leaflet of the tricuspid valve. It was small when diagnosed at in May (6mm x 1mm). It was not present in an echo done 18 months prior.
It is significant to note I am a metastatic breast cancer survivor, mets to underarm lymph nodes, and currently a NED. I received large doses of chemo (abraxane, taxol, paclitaxil) and had congestive heart failure during treatment. I have ground glass opacities in my lungs, diagnosed as infectious or inflammatory. Also, in March of this year I had septic shock, bilateral pneumonia, etc., etc., which required a 13 day hospital stay.
I have extreme fatigue, but also have chronic anemia. The clinic wants to perform a TEE next month. If surgery is required to remove the tumor I’m told it will require open heart, due to reconstruction using latissimus muscles.
The tumor seems so small. My hometown cardiologist has suggested leaving it alone to see if it will resolve on its own by dislodging and going into my lung.
Any information is much appreciated!
Its hard to comment specifically without seeing the images themselves. In our center we would generally adopt a robotic approach for tricuspid lesions when feasible. The differentials for a tricuspid lesion are wide, how are they so sure its a tumor?
I had echo and my Tripcusid Valve came back as normal but there is mild to moderate tricuspid regurgitation. Right ventricular systolic pressure is ’27-32′ mm/HG. Right ventricular Systolic pressure is normal. I have a lot of swelling in my legs and stomach and leg pain which gets worth if I am under stress or at night. It basically feels numb but this does fluctuate. I take hydrochlorothiazide daily. They thought I had restless legs and I am taking Horizant at night but now wondering if this due to my heart. My cardiologist says to wait a year to check since I had a good stress test. I did have artifacts that appeared on film before I took the stress test but improved when my heart was stressed. Wondering if I should get a second opinion and how common this is.
The restless legs, leg pain, and abdominal pain will not likely be related to mild to moderate tricuspid regurgitation. Stress tests are far from perfect but can provide reassurance, the disappearance of defects on the stress portion is always reassuring and often suggests artifact. I would recommend to discuss your questions with your cardiologist and of course if not reassured you can always seek a second opinion.
Hi Dr. I am a 67 y.o. female with 2+ tricuspid regurgitation. A normal resting heart rate for me is 60’s and irregular. Sometimes when I’m resting my heart rate will go to mid 80′ to 90 which is uncomfortable so I take 12.5 metoprolol. Past 2 – echos have shown trace mitral, trace, pulmonic regurgitation. I’m a petite small framed woman. I become very dyspneic with even minimal exertion. Sometimes I experience shortness of breath at night when I’m trying to sleep which is very frustrating and uncomfortable. Should I worry? The thought of possible open heart surgery scares me. Is there a less invasive procedure for this? I see a cardiologist once or twice a year who when asked: Can this get worse his answer is “over time yes,”
Forgot to mention my ejection fraction is 60. Is this normal?
Thats normal.
2 + tricuspid regurgitation is not a cause for concern and is not likely related to the symptoms. Its more likely to stay stable over time than progress.
I am 27 years old and I had an echo done recently. Everything came back normal except for a few things:
1. Estimated right ventricular systolic pressure is not reported due to an
insufficient tricuspid regurgitation signal.
2. There is trivial tricuspid
valve regurgitation.
3. There is trivial pulmonic valve
regurgitation.
4. The pulmonary venous pattern showed blunted systolic flow.
Everything else was normal size and function. Should I be concerned about this?
Looks pretty normal to me with respect to the information you provided.
My husband diagnosed with mild aortic regurgitation with ejection fration 49.he is 36 year old and overweight and facing high bp problem from last 10 years. Is it possible to competely reverse mild aortic regurgitation to normal condition by medication and good life style. Should he join Zim to reduce his weight with this heart condition.is mild aortic regurgitation patient have bad heart condition in future.?
Hi had my first echo . Everything was normal except 31. /32 hhmm. Form said symptom or mild ph. I’m having panic attacks for first time in life over this. I’m 42 healthy mom. Cardiologist said high side of normal. Repeat echo I. Year. Would you consider this normal
I had an ecg and it came back with mild vitral regurgitation and mild to moderate tricuspus valve regurgitation.im 59 years old and have angina with lots of fluttering and feel like i have pills stuck in my throat and middle of my chest also shortness of breath and fatigue and sweats. What should i do?
Your echocardiogram report does not have any real cause for concern, you’re symptoms otherwise are worrying and you need to get those checked by a specialist asap to rule out serious causes.
Hi Sir,
During regular body check ups last month, my echo report shows that mild TR,mild PAH(40mmHg).No RWMA, normal LV,R V function, No effusion. Should I be worried? I am fit and healthy .Doctor advised me to do regular exercise and absolutely no need to worry. Please share your opinion on this.
Your echo is pretty normal in that there is no clear cause for concern. The mild valve regurgitation is nothing to worry about.
Thank you so much sir for your reply. I am worried about mild PAH(40mmhg) . Is it normal? My chest X-ray also all normal findings only.
The echo is not an exact science and only provides a rough estimate. If your physician feels this is normal and that you have no other cause for concern then attention to factors such as weight, lifestyle etc should be sufficient. Its probably a good idea to have the PA pressure rechecked in a year to ensure stability.
Hi Sir,
I am 29 Male, During regular body check ups last month, my echo report shows that mild TR,mild PAH(40mmHg).No RWMA, normal LV,R V function, No effusion. Should I be worried? I am fit and healthy .Doctor advised me to do regular exercise and absolutely no need to worry. Please share your opinion on this.
Any update?
what will be the treatment plan for severe regurgitation (Tricuspid )in a 65 year old. Highblood pressure is under control.
It depends on many factors. It’s important to find the mechanism of the TR before determining a treatment plan. I recommend asking your Dr what they feel the underlying cause of the TR is.
Hi, Sir
I am aparna 38 years old female. Due to chest pain, I concerned cardiologist, he performed ECG, Echo, and stress test. In Echo it is detected that mild TR. Later at night times my heart is running fast. I troubled two weeks. I concerned Raghava Sharma, famous cardiologist in Guntur. He performed Holter 24 hours monitoring. In that doctor revealed that I have SVT. Now I am using farmocid 40 mg for gas problem every morning and Propranolol 20 mg (half in the morning and half in the night). Now my palpitations at night are controlled. But I have chest pain that comes sharply for 30 seconds to 1 minute (10-15 times a day), and sometimes shortness of Breath and night times I found that my heart is too heavy to work. Now I cannot even do my regular work also with concentration. I was working as computer operator now.
Sir, I request you is mild TR and SVT effect the heart. Pleast give me suggestion what to do now. You are only hope for me sir.
Hi, Sir
I am aparna 38 years old female. Due to chest pain, I concerned cardiologist, he performed ECG, Echo, and stress test. In Echo it is detected that mild TR. Later at night times my heart is running fast. I troubled two weeks. I concerned Raghava Sharma, famous cardiologist in Guntur, Andhra Pradesh, India. He performed Holter 24 hours monitoring. In that doctor revealed that I have SVT. Now I am using farmocid 40 mg for gas problem every morning and Propranolol 20 mg (half in the morning and half in the night). Now my palpitations at night are controlled. But I have chest pain that comes sharply for 30 seconds to 1 minute (10-15 times a day), and sometimes shortness of Breath and night times I found that my heart is too heavy to work. Now I cannot even do my regular work also with concentration. I am working as computer operator now.
Sir, I request you, is mild TR and SVT effect the heart. Pleast give me suggestion what to do now. You are only hope for me sir. Awaiting for your response sir. Please give me suggestion as early as possible.
I am aparna, 38 years old female. I have mid TR and SVT. Now I am suffering with chest pain and shortness of breath. Now I am using propranolol 20 mg per day. Please give me suggestion.
The mild TR can be considered normal and nothing to worry about.
Hi Sir,
I am Appu aged 38 years female. I have mild TR and SVT problem. Now I am taking propranolol 20mg per day. I have chest pain and shortness of breath. Due to this I cannot concentrate on work. Please give me your valuable suggestion Sir. Is Mild TR effect heart. I am worried about it.
The mild TR can be considered normal and nothing to worry about.
Hi Doctor,
My age is 35 becasue of ECG abnormality i have done my echocardiography.
My echocardiography comments are normal except two
Trileaflet aortic valve with trace aortic incompetence
Normal right ventricular systolic function. Trace tricuspid regurgitation PASP 32mm Hg.
Can you guide anything to worry about and need treatment.
Thanks
Looks normal to me.
Hi Dr. Mustafa, I am 69 years old with a history of heart disease, and an implanted ICD for 25 years. Recently, I had a Transthoracic Echo performed at the VA Hospital which I strongly disagree with the reader’s assessment of my ejection fraction in that this doctor stated was between 50-55%. Prior echocardiograms at private hospitals showed my ejection fraction to be in the 40-45% range. This report showed my Tricuspid Valve has mild regurgitation, PAP 35 mm hg. Aortic Valve has mild aortic sclerosis with a trace to mild regurgitation. Mitral Valve shows MV chordae are thickened with mild regurgitation. I would like another opinion to see if I should seek possible Valve repair to prevent things from becoming worse. Your opinion will be appreciated!
For mild valve disease no intervention is needed and there is no cause for concern.
Hello Dr Ahmed I have written to you before I had an MI nstemi in January 2017. Cardio said it was mild however I had two stents. I have just completed a echo stress test 3 weeks ago which I passed with no problems.EF was 60 My cardio said to comeback and see him in a year. However when I went over my echo report it states tricuspid valve :trivial mitrial and tricuspid regurgation with tricuspid velocity suggesting mild to moderate pulmonary hypertension ! Peak pulmonary artery pressure suggested was 48mmhg. To be honest this has made me panic I already suffer from anxiety disorder. Everything else was normal with the test. Why wouldn’t the cardio Dr think this wasent an important finding. My GP has not mentioned this when he went over the results with me. I see him next week and I will go over this with him. I would just like your opinion on this thanks in advance. Regards Mark.
Its often more of a bystander than a primary problem and therefore it is being treated in most cases simply by adressing overall cardiac health and risk factors. For this reason many physicians don’t bring it up as thy aren’t treating it specifically.
Tks Dr so I assume that if I keep on exercising diet medications I can improve this pressure? Everything I have read says this has no cure and is life threatening! All other results on stress echo was normal including heart and valve dimensions. I had a chest X-ray and this was normal as well. Thank you for your help. Regards Mark.
Hello Doctor,
Recently as part of routine checkups , my Echo shows Mild Concentric LVH. Normal LVH/TV function. No RWMA. No AR/MR/TR.
IVSd is 1.17cm and LVPWd is 1.06cm. Doctor told me it is due to hypertension and he prescribed 20mg b.p tablets for 15days. After that he advised me to take diet control . Dear Sir, Can Mild LVH be reversible if I control my blood pressure over one year. My B.P reading was mostly 125 to 135/ 80.
Please suggest me.
When I was pregnant a heart scan showed my baby had mild tricuspid regurgitation at 20 weeks gestation and all they said was it should clear up by 28week gestation however it didn’t clear up.
The doctors didn’t really explain what it means and said it can be linked to chromosome abnormalities.
They did say they will rescan her when she was born but then a routine peditrician checked her with a stethoscope and said her heart sounds fine then discharged her.
What symptoms would a baby show if there was still tricuspid regurgitation? And should I be worried.
Thank you any information would be really appreciated!
I wouldn’t be concerned with mild tricuspid regurgitation, it does not associate with any symptoms.
I recently had an echocardiogram that showed mild tricuspid regurgitation and slight mitral regurgitation.. I had PAP of 45. I am a runner but have had shortness of breath and chest pain for a while. Doctor wants to repeat the echocardiogram in one year. Is this too long to wait?
A yearly echocardiogram in this instance seems reasonable if suggested by the cardiologist.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at MustafaAhmedMD
Hi Dr. I have mild to moderate aortic regurgitation..mild to moderate TR and mitral valve prolapse with trace regurgitation. Was diagnosed 4 years ago and Dr. Said it has not changed. This has caused me great anxiety with many anxiety symptoms. Should I be this worried?
No real cause for concern, you have mild valve disease only and no specific treatment recommended for the valves here. Keep your regular check ups.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
My mother has been diagnosed with “Grade 2 TR”
Can someone let me know how severe this is?
Not very severe.
Hi
I was diagnosed with a mild leak in tricuspal.
My Dr said keep taking BP meds (Lisinopril) and keep working out , lose weight, keep calm etc
Any other pointers?
How can I prevent it developing into a more severe condition, how often should I get a check up?
She noted it by a heart murmur and I had a heart ultrasound.
I am 56 and pretty active.
A mild tricuspid leak is relatively common and not of any real concern. The overwhelming majority of mild leaks will never become a significant clinical issue.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
Hi
I was diagnosed with a mild leak in tricuspal.
My Dr said keep taking BP meds (Lisinopril) and keep working out , lose weight, keep calm etc
Any other pointers?
How can I prevent it developing into a more severe condition, how often should I get a check up?
She noted it by a heart murmur and I had a heart ultrasound.
I am 56 and pretty active but need to lose some weight…
Hi. I had infectious endocarditis about 2 months ago. I’m 20 years old. I had an echo done at the hospital and they said I had a little bit of a heart murmur and a small tear in the lower right ventrical of my heart. What does that actually mean and should I worry? And what should I not do to prevent it from causing me worse problems?
That doesnt make much sense in terms of the finding, do you have details of the report.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
Hi, my mother has echocardiogram this january 2017 and it showed severe tricuspid regurgitation and severe pulmonary hypertension. My mother doesn’t have symptoms at all. Creatinine is fine, no swelling on legs and abdomen. She can still go for a whole day tour, and can climb 2 flights of stairs without shortness of breath. The cardiologist said there was no problem with the reading and she was even allowed to go on a flight. Is it possible that the echo was wrong?
Im not sure about the echo without seeing it. Regardless if she has been diagnosed with severe pulmonary hypertension then she should be under the care of a dedicated pulmonary hypertension specialist and treated appropriately. Its difficult to comment on the suitability for flying without fully evaluating her.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
My mother, age 74, had aortic vale replacement surgery almost 3 months ago. After surgery she aspirated 3 times after which a trech was placed and she has been on a ventilator for two months. Two weeks ago, finally, she came off the ventilator completely. A week after she got off the ventilator, she started to accumulate a lot of fluid and her pee output was reduced. Echo showed that her tricuspid valve is regurgitating. She is currently on lasix (diuretics) to reduce the swelling by getting rid of the fluid in her body. In my opinion, lasix is unable to reduce her swelling as a result of fluid accumulation. She is weak an seemed very dejected and hopeless.
My question to you is whether it’s a good idea to go ahead for the Tricuspid valve repair? I would be very grateful for your opinion or advice!!!!
Do you have full details of the echo report? Of course any immediate repeat surgery after a surgery with a complicated course needs to be done so with caution and careful consideration.
I have a mitral valve which my doctor says has a significant leak and a tricuspid valve with a smaller leak. This was discovered when I ended up in the hospital panting like crazy but felt I wasn’t getting any air. I was also very anemic….in fact they said my blood work was incredible. Had to have a transfusion the night before I was released from hospital. If I don’t have surgery, what will happen?
Do you have details of the echo report?
Hi sir.i have heart palpitations and some pauses.so I went for echo.they mentioned trivial tr.does it progressive.how it is serious
My Echo report says “frequent VPCs noted”, “mild (grade I/III) mitral regurgitation and trivial (grade I/III) tricuspid regurgitation”, “there is mild PH. The estimated pulmonary artery pressure by TR key is 35mmHg”,”there are no clots, vegetations or pericardial effusion”, “cardiac septae are intact”, “aortic arch normal, no coarctation”, “Lvef 0.55”, “LV systolic and diastolic function normal”, “no regional wall motion abnormality”, “LV size, wall thickness and contractility normal”. Pl explain what is further procedure needed.
The echocardiogram itself appears relatively normal and suggests the heart is structurally normal, you were noted to have regular PVC and it may be useful to wear a heart monitor to characterize these further.
Thank doctor for the reply. An Ambulatory holter was put for 24 hours. There were multiple mostly monomorphic ventricular ectopics (26%) with frequent bigeminy and occassionally couplets but no malignant forms or ventricular tachycardia seen. In 24hrs total 97755 beats out of which 25276 were ventricular beats. There was single atrial ectopics but no atrial tachycardia. No significant sinus bradycardia or sinus pause. No evidence of silent ischemia. Pl tell me whether I will have to live with this irregular beats rest of my life. There is lot of discomfort. I feel as if I am not able to breathe full. What will be further procedure.
I was diagnosed with preserved left venctural function with mild mitral and aortic regurgation. Is this a cause for concern? I get sudden bouts of high blood pressure and rapid heart beats. Is this a common issue or something to be of concern? I am only 25. I have also low red blood cells that are not due to iron defiency. Could this be caused by the regurgation?
Such mild degrees of regurgitation are no cause for clinical concern and not likely related to your symptoms.
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
Thank doctor for the reply. An Ambulatory holter was put for 24 hours. There were multiple mostly monomorphic ventricular ectopics (26%) with frequent bigeminy and occassionally couplets but no malignant forms or ventricular tachycardia seen. In 24hrs total 97755 beats out of which 25276 were ventricular beats. There was single atrial ectopics but no atrial tachycardia. No significant sinus bradycardia or sinus pause. No evidence of silent ischemia. Pl tell me whether I will have to live with this irregular beats rest of my life. There is lot of discomfort. I feel as if I am not able to breathe full. What will be further procedure.
My family member was recently told he needed valve replacement surgery from his cardiologist. After further testing he was told that he has a congenital birth defect with the tricuspid valve. They are going to do an angiogram and then the valve replacement surgery ASAP. He is going to have the replacement done locally at Riverside Community Hospital in Riverside, California. Should he have a second opinion? I have read how this is not a commonly performed surgery.
In general my opinion is that valve surgery should only be carried out in high volume centers with experienced operators.
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
Hello. I have a question back in 1993 I was diagnosed with mitral valve prolapse and they put me on a medication that I couldn’t take because I had low blood pressure so I had to exercise and change my diet and the pain for the most part went away well now I stop smoking in gained weight and now I have the pain that I used to have back in the nineties after I lost so much weight and I stayed at 119 – 122 lb from 1996 cuz I went on a 3-year plan an exercise to 2012 I stopped smoking the last day of 2012 and I started gaining weight 2013 so I’ve gone up 30 lb since 2013 my question is could that of because I gained weight that I have to paint again because now I can hardly walk at my Fast Pace that I used to before I start feeling sharp sharp pains in my chest and shortness of breath and by the way I just turned 54 years old the 19th of August. I had an echocardiogram done also an EKG and bloodwork done now the echo shows that I have a trace of tricuspid valve regurgitation so I’m wondering if things have progressed worse because I didn’t have this kind of pain or shortness of breath back then of course I was younger but now I do and I’ve gone down 10 lb I would from 155 to 1:44 for now since last year what would be your recommendation
The trace tricuspid regurgitation is basically a normal finding and nothing to worry about. It is not the cause of symptoms. It may be a good idea to get fit again and lose weight etc.
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
I am 31 y.o.. my echo revealed that..
Normal pulmonary artey pressure with pulmonic regurgitation.
Trivial tricuspid regurgutation.. should i worry?
The trivial tricuspid regurgitation is not a cause for concern.
………………………………………………………………………………………………………….
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
I have trace pulmonic, trace mitral valve regurgitation. I also have 2+ tricuspid regurgitation. Add to this is that I get palpitations and elevated heart rate. Pulse is usual 60’s and often irregular so when it goes up to 80-90 it’s uncomfortable as I am a thin 5’2″ female who weighs about 103 lbs. BP can range from 80’s to 100ish systolic and 60ish to 90ish diastolic. Can any of these valves be treated minimally invasive? I have CLL and if I have to have treatment (non-chemo) there is a concern of the drug causing a-fib. I’m really scared!
None of your valve problems are very concerning, they don’t need attention at this stage and are not close to needing attention, there is a chance they never progress.
you can follow my twitter at @MustafaAhmedMD
I was hoping you might answer a question about tricuspid valve prolapse 3. Due to damage from pacemaker wires. I was told it was repairing itself after pacemaker was removed. This was close to 3.5 years ago. Lately I’ve had intense irregular heartbeats that worsen when laying on left side. I have moved and have not found e new cardiologist who I trust. Is it possible the valve has worsened? I ha w gone to the ER once since things worsened and was sent home. EKG appeared normal I was told. But no one ever had me lay on my left side and then listened to my heart. My BP seems high also. Thank you in advance, if you are able to answer any questions. I appreciate t very much. I am a 47 yo female.
It sounds like the leak of the valve got better once the pacemaker wires were removed. If that was the mechanism and the leak was significantly reduced there is no reason to suspect it would have worsened. Due to the symptoms you are having i would recommend erring on the side of caution and getting an echocardiogram, even if simply for reassurance. Laying on the left and listening is more sensitive to the mitral valve.
My daughter is 44, has Down Syndrome, and has just been diagnosed with moderate tricuspid regurgitation and mild pulmonic regurgitation. What do we need to do about this?
Nothing urgent. In general for these issues in isolation no specific treatment recommended. Would just recommend following over time.
I’m a 22 yr/old female. Recently, my doctor heard a heart murmur (never been told I had one before) which she thought sounded benign but she sent me for an echo to double check as I didn’t have a fever/not anaemic/not pregnant etc. The echo found trivial regurgitation I think of one valve (I don’t know which) but the valves are structurally normal, she didn’t say they found anything else. My GP said this means my murmur is benign and the regurgitation explains it so no need to do anything else and no need to worry.
I just don’t see how trivial regurgitation would cause me to have a murmur if it’s such a small leak. What do you think? Do I need to be concerned about the murmur and does trivial regurgitation tend to get worse over time?
The trivial tricuspid regurgitation is not causing a murmur and is not a cause for concern.
you can follow my twitter at @MustafaAhmedMD
Just had an echo. Everything appears normal except for “mild left atrial enlargement” and “insufficient TR jet.” Not sure what these mean or if I should be concerned.
The mild atrial enlargement and the insufficient jet are not in general causes for concern.
you can follow my twitter at @MustafaAhmedMD
Dear doc…my in-law’s husband is effected by pulmonary hypertension. recently he was fainted at the door step and following that he vomitted with blood and went short of breath… we admitted him in gleaneagles hospital.. the doctor said his lungs pressure is very high where normal is 18 to 20 but his lungs are pumping at 120… he had been having this problem for past 3 to 5 years… should i be worrying… as i have research the life expentacy for this condition is very low… pls help me…
He needs to be under the care of a pulmonary hypertension specialist with training in advanced disease if the PA pressures are indeed 120.
you can follow my twitter at @MustafaAhmedMD
Thank you for ur reply doc
Hi There. My husband had an anterior MI when he was 50 years old. Two years later he underwent triple bypass surgery. This was 2 years later (he is now 76 and reasonable fit, non smoker, low BP and Cholestrol levels. More recently he experienced some chest pain and breathlessness. Following a short admission to hospital he was diagnosed as having had small MI and 2 stents to his left side were inserted. More recently angina was diagnosed following some chest pain and breathless while he was climbing a hill while deer hunting. Stress test showed SOBE. His Rt grafts now appear to be narrowing and one is completely blocked. The stents on the left side also are not that good. Medications were changed and surgery was not an option. I October 2017 he had a cardiac echogram to determine his right sided heart function as he has been experiencing fatigue, declining exercise capacity and mild SOBOE. Findings show he has severe (free) tricuspid regurgitation. PASP cannot be estimated due to TR severity. The right heart appears to be moderately dilated with preserved free wall contraction. His specialist said to only come back and see him if we are worried. Should we be? Should we push for tricuspid valve repair in an attempt to prevent later heart failure?
Its a complex issue regarding the tricuspid valve disease. Any decision to repair this needs to be in an experienced center after a thorough work up. RHC (right heart cath) would be required to accurately measure the PA pressure. The question here is what is causing the symptoms? The blood supply to the heart, the ventricular function, the valve disease or a combination of the above. These questions need answering prior to proceeding with any intervention.
you can follow my twitter at @MustafaAhmedMD
Hi,
I had open heart surgery in 2014 due to endocarditis. I’ve been fine since. I’m now 27 and this past 6 months I started getting swollen legs and severe pain in my abdomen. I went to the hospital 3 months ago and they told me that I have a leak in my tricuspid valve and need surgery. They made it seem like I was in desperate need to get it fixed yet sent me home. I have been trying to get healthy and I am seeing a cardiologist that now is saying that my tests look great don’t need surgery. But he will eventually run his own tests.
I am starting to get pain throbbing under my left arm in my chest, can’t breathe when I lay down, pressure in my neck, should I be worried? Especially about the pain in the side of my chest?
Thanks for your time and help.
Sincerely,
Michelle
If you are worried and you are having symptoms you should seek evaluation for sure.
In general the leaky valve itself will not lead to pain in the arm or chest however other causes need to be ruled out.
Dear Dr Ahmed,
Hope you can help with this as I’m a bit confused.
My son, who is 19, went in for a small op that required a general anaesthetic. He was given an echocardiogram which showed ‘trace tricuspid regurgitation’. Some members of other forums say they have BOTH tricuspid and mitral regurgitation. Is mitral not aother name for tricuspid?
Is ‘trace’ tricuspid regurgitation classified as a ‘condition’? ie, should this be declared on travel insurance?
(He is a healthy teenager with no health issues.)
Any advice would be appreciated.
Yours sincerely.
Ammi
Trace TR means a trace leak across a tricuspid valve and is a normal finding of no concern. The tricuspid and mitral valves are different.
you can follow my twitter at @MustafaAhmedMD
My father eco report says trace tr v max1.42 m/s pg max 8.1 mm hg & thinned out and akinetic mid and apical inferrior wall apex mid and apical septum plz suggest me what to do
The TR and the pressures are normal, the heart itself appears to have sustained damage likely from a heart attack, seek evaluation from a cardiologist.
Dx with breast cancer 2016. Taking AI. Oct 2016 at 136 lbs sedentary EF 70%. Oct 2017 110lbs and walk 3 miles daily EF 60%. Why the decrease? Also mild MV regurg. Heavy coronary atherosclerosis on chest CT. Lipids wnl. Unable to take statins. Now becoming increasingly fatigued and sob. CP at rest that radiates to arms and legs. Cards says not cardiac. Should I stop AI?
Thank You
The decision to start or stop the medication should only be taken by the prescribing physician or the treating one.
With regard to the EF, 60 is normal. Its more likely that there has been no change, and that both were essentially normal. If you are concerned then have the performing / reading physician glance over the scans again. But be reassured that 60% is considered normal.
you can follow my twitter at @MustafaAhmedMD
Hello Dr. Ahmed,
My 14 yo daughter was diagnosed with moderate tr in 2014. Starting leaking “somewhat” more” in 2015. New mri shows regurgitant fraction 23-26%. Rv ef 53%. End diastolic rv volume is 1.5 times that of left. 2015 echo showed borderline rv volume overload. Also “Qp:Qs=.98 possible small defect asd or vsd”.
Do you think she needs a cat or cardiac cath? Is it possible to guess how long it will take to reach severe stage? Is it always done open heart?
Thanks much!
The step I would recommend next is an evaluation by a Pediatric Cardiologist to determine mechanism of tricuspid regurgitation and also to evaluate potential factors that could lead to right ventricular dilatation. Only after that can further testing be determined.
you can follow my twitter at @MustafaAhmedMD
Hello,
My youngest brother started experiencing pain in the heart, according to his description, for few seconds from every other week back 6-8 months ago. He is 17 years old. Lately, he started experiencing the same pain for longer and more frequent. The frequency is daily or twice a day, the duration is almost a minute. He did an ECO test on Jan. 9th. and the results were normal except for the following:
1) Mitral Valve: Mild anterior mitral valve prolapse with Occasional trace mitral regurgitation.
2) Tricuspid Valve: trace tricuspid regurgitation present.
I am not a medical doctor at all. Nonetheless, after several trusted websites, it seems that some MDs recommend taking an action of surgery before things get worse.
My question hence, shall we take an action to do a surgery?
Is there any threat on his life at this point?
Any insights or recommendations?
Many thanks Dr. Mustafa, I highly appreciate your time and support.
All the best,
Faisal
With regard to his symptoms I cannot really comment without evaluating and reviewing the history fully. With regard to the mild mitral and tricuspid regurgitation they can essentially be seen as normal findings and certainly would not need any treatment never mind any surgery.
Hi sir plz help
My echo eeports says I have mild MVP of AML with Mild MR and AR very mild.. and what is TR (trivial)
Nd sir mild Thickened aortic valve is it bad ?
Is it dangerous iam 30 year old male plz help me im alot worried about this mvp i have my childrens want to do something for them….nd im cricketer can i continue play cricket now when i play cricket my heart goes fast alot and some time suddenly goes fast when i go alone some where nd cant go for work im very sacred plz tell me about my mvp nd also tell can i take anxiety medican in mvp
My Resting heart rate is low 45bpm to 50bpm when i stand walk normaly its beats 70bpm or 75bpm is it oky?
But when i walk run its goes fast
I use to play cricket alot
So is it slow by mvp or being in sports running plz reply i had holter monitor test its said sinus bradicadya .. should i worried about peacemaker? My bp always count 110/70 when i sit when i het tens ots goes high plz reply sir
Mild MVP with mild MR is generally not a cause for concern. Trivial TR is a normal finding.
Thanks sir for your reply
Sir what about my resting heart rate and other heart rate plz tell me about this and also my BP always 110/70
Why its happen nd i have something Prick in my chest is because of mvp?
Hi sir plz help
My echo eeports says I have mild MVP of AML with Mild MR and AR very mild.. and TR (trivial)
Nd sir mild Thickened aortic valve is it bad ?
Is it dangerous iam 30 year old male plz help me im alot worried about this mvp i have my childrens want to do something for them….nd im cricketer can i continue play cricket now when i play cricket my heart goes fast alot md some time suddenly goes fast last time note 130bpm when i go alone some where nd my resting heart rate is low its like 50bpm 45bmp 55bmp when i walk its goes 70bpm or 75bpm ..i cant go for work im very sacred plz tell me about my mvp nd also tell anxiety treatment when i feel fear some time i take 0.25 alprazolam
My bp always 110/70
Hi dr. Mustafa,
A quick question – why do all cardiologists say that mitral valve prolapse with trivial regurgitation & tricuspid trivial regurgitation are of no significance?
While, many medical sources show researches done that point to cases in young adults where mitral valve prolapse on its on has triggered ventricular techycardia/fibrillation leading to cardiac arrest/sudden death?
I hope you’ll answer my question.
Because the overwhelming majority of MVP with trivial regurgitation is benign. There are some severe forms of bilateral MVP that are distinct in appearance and that are associated with the arrhythmias you mention, but they are the distinct minority.
Hi dr. Mustafa,
Does this mean that mitral valve prolapse with trivial regurgitation & tricuspid trivial regurgitation wouldn’t lead to life-threatening arrhythmias?
I am asking because I’ve been recently diagnosed with the above + 2 additional false chords on the top of my heart they say?
Aren’t all of the above too much? I also have frequent PVCs, a couple of Holter Monitoring showed about 1000 per day.
I’ve had a few episodes where my HR reached 175 bpm at rest. But the increase & decreased has happened gradually. Once I see/feel my HR at about 100-105 bpm, I feel extreme panic and it then increases gradually over 1-2 minute period. It lasts no more than 2-3 minutes. None of those episodes have been recorded on ECG.
All of the information mentioned above scares me a lot and I can no more live a normal life. I am only 28 year old, and I feel like a disabled person. Please, could you share your thoughts?
Hi dear what happening with when you have fast heart rate some time i have also this its goes so fast i have listend that this is dangerous
Let’s hope dr. Mustafa would answer that question.
Hi dr. Mustafa,
Does this mean that mitral valve prolapse with trivial regurgitation & tricuspid trivial regurgitation wouldn’t lead to life-threatening arrhythmias?
I am asking because I’ve been recently diagnosed with the above + 2 additional false chords on the top of my heart they say?
Aren’t all of the above too much? I also have frequent PVCs, a couple of Holter Monitoring showed about 1000 per day.
I’ve had a few episodes where my HR reached 175 bpm at rest. But the increase & decreased has happened gradually. Once I see/feel my HR at about 100-105 bpm, I feel extreme panic and it then increases gradually over 1-2 minute period. It lasts no more than 2-3 minutes. None of those episodes have been recorded on ECG.
All of the information mentioned above scares me a lot and I can no more live a normal life. I am only 28 year old, and I feel like a disabled person. Please, could you share your thoughts?
I think that if it would reassure you, you should get an opinion from an electrophysiologist.
HI !
May I know if I should concern for mild tricuspid regurgitation?
If thats the only issue then it is not a concerning finding.
you can follow my twitter at @MustafaAhmedMD
I havent seen my cardiologist yet. i just got my 2d echo results and most of it are normal but theres only one that says MILD TRICUSPID regurgitation. what should i expect to hear from my doctor upon seeing this. is this normal or if not is it something serious?
In general its not a concerning finding, they will likely not even feel the need to mention it.
you can follow my twitter at @MustafaAhmedMD
I am a 25 y/o female with no pertinent pmh. I have trace tricuspid, mitral, and pulmonary regurg on echo. I also feel like my heart rate is irregular. I feel palpitations often that feel like a tickle in my throat and make me feel like i have to cough. I have mild chest pains each week, not induced by exercise. I am in good shape (run 3-4 times per week)but resting heart rate is around 80 – 90 and bp is usually 110/68 – 120/80. Do you think I need to complete any follow up?
The echo itself is basically normal. If you have symptoms that are of concern to you then follow up is advised.
you can follow my twitter at @MustafaAhmedMD
Hi Dr. Mustafa,
I am 28 years old now and I have been experiencing 3-4 seconds of fast heart rate since I can remember. I was born with a heart murmur that eventually went away. At the age of 19 I started to get chest pain that would cause black outs but I would still be conscious. I would be able to hear you but not move my body for seconds and then I would come too again. That happened about 6-7 times in one year at different and random times. I went to a cardiologist who never really found anything wrong. Literally a year after that I started experiencing some tingling and I was sent to a neurologist who did a test that apparently showed I got mild seizures. After 3 months they redid the test that came back negative and no further explanation was given. At the age of 23 I started experiencing a lot of hot flashes with dizziness, fatigue and still sudden racing heart. I got a 2 DIMENSIONAL ECHOCARDIOGRAPHY WITH DOPPLER and they told me everything came out normal. Now thanks to MYChart I am able to look at my current test and past ones. I saw that they found, There is trivial tricuspid and pulmonic regurgitation.” But it is a normal finding according to every research I’ve done. The doctors never mentioned this to me either, which I felt like they should have but I understand that they don’t believe they should because its not harmful. As I just found this out and I am now 28. I just had a holter monitor on the other day for another testing. Because in December I had another episode, this time as I was about to sit down my heart starting racing and normally it goes away after only a couple seconds this time it wasn’t. I kept coughing due to the lack of oxygen from my heart racing. After what seemed to last 3-5 minutes half my body not my legs but the upper part of my body started tingling and growing numb it didn’t go numb but it was pretty close. My husbands grandma has heart problems as well and she had a heart monitor around and they checked me at that time and my heart rate had gone up to 126. I didn’t go to the hospital because the doctors never seem to find anything. I was just wondering if you think it could be heart related or something else entirely.
The findings on your echo of trivial regurgitation can be considered normal and nothing to worry about from a heart point of view.
you can follow my twitter at @MustafaAhmedMD
Sir, my son age 13 yrs 8 mnth have recently advice an echo by doc and find trace TR, PASP-21mm Hg+RAP.
Is this worry about or it will automatically recover upto age of 16 as advised by my doctor or any medicine or treatment be necessary to treat this. He has no symptoms of fatigue etc but only his heart beat rate is increased… Plz reply asap
I was diagnosed after an echocardiogram with heart function good, tricuspid valve regurgitation is moderate to severe. This echo was done dec 2017. I had a echo a year before as well with the same diagnosis. Should I have a surgery repair before things get worse or do I need to be showing other systems before a surgery repair is needed? I am 63 and do not have high blood pressure or diabeties but for years(starting in my 20’s) have suffered from palpitations that were diagnosed as benign. Also a month ago because my cholesterol was elavated I started a statin (atorvastatin). On the same day I took my first statin am, while resting at night my heart went into a fib. My doc was puzzled because in the am I had walked my treed mill and worked the day and did some evening errands. Only after I showered and was watching tv on the couch did the a fib accur. Of coarse I’m convinced it’s the statin drug even though the doc doesn’t think so. To coincidental for me. After a hospital overnight was put on a calcium beta blocker (diltiazem 24 hr er) I was only give a rate of 1 because I am a women and none of the others problems applied to me. I have not taken the statin lowering drug since and went on the dean ornish diet and have yet to have my cholesterol checked. Hoping for big improvements when I do. My real concern is the tricuspid valve regurgitation. Your option will be appreciated. Thanks
Timing of surgery in tricuspid regurgitation is complex and somewhat unclear. Importantly we do it in the setting of a muti-disciplinary valve clinic. It depends on many factors. In isolated tricuspid valve disease, the presence of severe tricuspid regurgitation, symptoms and signs of heart failure, acceptable heart function and acceptable operative risk and other factors are taken in to account.
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Hello. I’m 30 yr old and diagnosed with severe tricuspid regurgitation and enlarged right ventricle. I’m also 26 weeks pregnant. When I’m closer to due date well schedule an induction. I’m working with a team of doctors all an hour away. My last labor only lasted 30 minutes. And closest hospital is 30 minutes away since I live on the back road to nowhere. What concerns should I have about going into early labor? Or about being pregnant with this condition in general.
In general tricuspid regurg should not pose an issue with pregnancy. With regard to the right ventricle it depends on the function. If the right ventricle is failing then there may be the need for close supervision and a specialist team. I would ensure this is discussed with the obstetric/cardiology teams well in advance.
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I am 28 years old with moderate persistent athsma. We did an echo to rule out cardiac causes such as pulmonary hypertension as I was having lots of chest pressure and some mild pain and felt like my lungs were exploding and not responding well to corticosteroids/bronchodilators.
All results normal except for: trace/mild pulmonic regurgitation, trace tricuspid regurgitation, and trace mitral regurgitation. It also says lipomatous i teratrial septal hypertrophy.
Should I be following up on any of this and could it be affecting my athsma?
The valve findings are basically normal.
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Hello Dr. Mustafa, I am a 50 year old female recently diagnosed with mild to moderate Tricuspid Valve Regurgitation. I had a normal echocardiogram in 2008, but then in 2017 this finding appeared. Starting in 2008, I took a drug called Cabergoline, for four years. This medication has been correlated (though findings are mixed) with mild to moderate TVR, and it is the only risk factor I have for this disease. My heart function is good and normal at this time based on my 2017 echo and stress test and those done in 2008. My questions are: Do you have any sense of how likely it is that my tricuspid valve regurgitation will progress to squarely in the moderate range, or perhaps to severe? And, in what time period does progression oftent occur? Studies on this are few (or perhaps I have missed them) and on male older samples so it is hard for me to get a sense of this. At present I’m trying to do my best to maintain good heart health, have good cholesterol and fairly good eating and exercise habits. I do have moderate persistent asthma, which intermittently leads to period of inactivity and I do take Albuterol inhalers, which may affect my heart. If you have any thoughts on the rate and/or likelihood of progression given my case or other comments, I would be very grateful to hear them. Thank you in advance.
Mild TR is very very common and is unlikely to progress, mild to moderate likely the same. In true moderate disease the progression will likely be tied to other factors such as pulmonary artery pressure, right sided heart function and overall heart health. I would recommend you don’t worry at the moment for mild to moderate isolated TR, the degree of leak should be checked at a later time a year for example and then the degree of stability can be determined.
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Thank you kindly for taking the time to respond to me. I really appreciate your assessment of my condition and found your words both helpful and reassuring. I will definitely continue to be monitored as needed. Many thanks again, CL
Hey doctor I am a 23 year old girl with no family history of heart disease. Im a 4th year med student & had some palpitations while in doing rounds and decided to get a ECG which showed extra systole and has elevated St outlet in II III and avF aswell as a prolonged QT interval & Irregular rhythm.
TTE showed moderate to sever tricuspid regurgitation with a Velocity 232cm/s PG
21.5
I have IVC dilation with diameter of 1.37.
Right ventricular dilation. All other valves are healthy and unaffected. Pulmonary arterial pressure is normal and systemic pressure is 100/70.
I can play sport but sometimes feel really faint and can black out as well as getting tachycardic on little exertion depending on the day. Occasional short lived dyspnea. Shall I consider surgery as a prophylactic before my right ventricle undergoes remodelling and permanent damage.
My body surface area is 1.47cm^2
Weight 48kg Height 5 foot 3
Complex decision making involved here. With severe TR and RV dilatation there is a case for intervention if the valve can be repaired, at your age you don’t want a replacement, at our center repair would typically be done robotically. Firstly you need an accurate assessment of cardiac size and volumes, then its important to evaluate to see the underlying cause of the TR. Abnormalities of the RV itself and underlying associated conditions such as ARVD need to be ruled out. In my opinion this should all be done under the care of a specialist valve team.
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Thank you so much for your time and words of advice. I appreciate it and will take it onboard.
Started with rapid heart rate in the 130’s and my bp would drop to 60/40’s, I throw pvc when I do it. My echo shows 60% ejection fraction and mild mitral valve regurgitation and mild tricuspid regurgitation
Hi mustafa, i am 37 year old. Was diagnosed with mild MVP since last 2012. But prior to that was also diagnosed with RHD. Last month I experienced sever dizziness, shortness of breath, fatigue, low bp, low potassium, low monocytes with pre diabetes FBS. I have undergone series of test to confirm it. My cardio put holter for 48 hours and was dianogsed with arrhythmia, frequent premature ventricilar depolarization in bigemy and quadrigemeny. Since february i lost weight abruptly like 4 kgs although i cant eat well coz i have gastritis and eventually vomit everyday (am not pregnant tho) plus i am always bloated and decreased urine. Yesterday got my echo result and it was confirmed that i still have my mild MVP but got shocked coz i have severe TR. (Venricular valves are normal in size including the RV and TV). Pulmonary pressures are also normal. But the doppler says i have severe TR. Im quite confused with the result. Tell me what to do! Thanks
Firstly the old echocardiogram needs to be evaluated to assess the tricuspid valve, then the new echocardiogram needs to be evaluated to see if the TR is truly severe. New onset severe TR, with normal PA pressure would be odd, and would need investigation to see what is the underlying cause. It may be that the read is incorrect and it is not severe.
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Thank you! Just got out from hospital admission. My new cardiologist says i dont have severe TR. And will have follow up check up 2 weeks time. The resident cardio made mention that there is a big probability that due to my MVP, TR might occur. My new cardiologists is not convince that I havr TR. Although i might undergo new 2decho to compare for the last one. He manage to let me use carviderol as needed when palpitation occur.
Does bloating and spasm may be a result of my chest pains or otherwise?
Thanks
Thank you for the informative article, Dr. Ahmed. Could I ask you whether people with a a mild tricuspid regurgitation are at a higher risk of developing endocarditis?
I was diagnosed in November 2013 with a mild tricuspid valve regurgitation and have been fearing of developing endocarditis ever since. I went for my check up again last year and my situation remains stable (visit to the cardiologist includes electrocardiogram and echocardiogram) More specifically, my results are (translated from Greek to English) : Heart murmur, Poor acoustic window. Normal left ventricle dimensions and wall thickness, with good contractibility, with no obvious hypokinesia (KE 71%, Teich, 68% Simpson). Good diastolic function (E>A, E’>A’). Normal left atrium dimensions. Right chambers of normal dimensions. Mitral valve: good opening and closing. Aortic valve: trifold, with good opening and closing. Tricuspid valve: good opening with incomplete closing and a small degree of insufficiency. Pulmonary valve: good opening and closing. Good aortic root width. Free pericardium. Possible existence of mild atrial septal defect. Conclusion: Normal dimensions of the heart chambers with good opening and closing function of the left ventricle. Small degree insufficiency of the tricuspid valve. Possible existence of a mild atrial septal defect.
Isolated tricuspid regurgitation is not a risk factor for endocarditis. Mild TR is basically a normal finding.
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Thank you very much for your reply, and helping put my mind at ease.
hello doc Ahmed…last 2016 my cardio required me to undergo some tests and one of it is to d echo….the conclusion says:concentric left ventricular remodeling with adequate wall motion and contractility with goodsystolic and diastolic functions…normal left atrial dimension with normal left atrial volume index…thickened right aortic cusp and non coronary cusp without restriction of motion…thickened mitral valve leaflets with trivial mitral regurgitation…mild tricuspid regurgitation…mild pulmonary hypertension with pulmonic reg…will i be worried with this result doc?
No cause for immediate concern or danger. I would recommend follow up.
I had an echo done and it showed I have severe tricuspid regurgitation and mild mitral valve regurgitation..Also mild L.V.ejection fraction and Apical wall motion abnormality noted..He did not explain any of this to me.Should I get a second opinion?I have chest pain and short of breath and tire out quickly. He said I was normal.Thank you for your input.
Was this a cardiologist?
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Yes it was a cardiologist.He put me on cartia xt 100mg and told me to take nitro.Well the medication is not working. He and his associate made me feel as if I was making up all of my symtoms.I have since made another appt with another heart Dr.Can you give me some pointers as to what to say to make them to please investigate as to what is going on with me.I will tell them I talked to you if it is ok.
Hi Dr Mustafa,I also have high blood pressure and I am about 50 lbs. overweight.I also have low thyroid problems.Thank you ,Peggy Barncord
D..Ahmed
I’ve been throw 2 open heart surgery 1 fix my the a value then off my leaking tricuspid valve but they couldn’t fix it so is there things I shouldn’t do
I had tricuspid repair 13 years ago. I now have moderate leak. Should they wait for it to be severe to fix it
Hello, I was hoping you could help me understand my husband’s Echocardiogram readings?
It reads as follows: Echocardiogram shows severe global hypokinesis and left ventricular systolic dysfunction with ejection fraction only 15%, mild left ventricular hypertrophy with left ventricular enlargement, massive biatrial enlargement, moderate mitral regurgitation, mild to moderate tricuspid regurgitation with right ventricular systolic pressure less than 35 which is within normal limits, stage III diastolic dysfunction, no obvious left ventricular thrombus or intracardiac shunting. Agitated saline bubble study negative. TEE
Can you tell me if this a bad reading or not? By bad I mean the test has unfavorable results. Thank you so much for any help you can provide, sir.
Its a serious situation. The heart is very weak and pumps at 15% (normal is 50-60%). Its critical that this is followed closely and appropriate medicines and management undertaken.
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My daughter she’s 4yrs6month old she got this mild tricuspid regurgitation (pasp 30mmhg) is this the serious case and can be treat? Im very worried about her doctor
Hi! What to do if diagnosed with TR trivial?
Nothing to do.Its normal.
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Greetings,
My mom lives overseas, where is no cardiac facility – not much medical infrastructure all together. Following a long term chest pain, she had an ECG done and an Echo Doppler. Her blood work came up good, expect for HbA1c was 7.2% and Cholesterol was 6.30mmol/L. On the echo doppler, it says all normal except a minor leak from the triscupids valves. I don’t know what it says on the ECG unfortunately. But the local doctors say she needs a stent. But there is no facility where she can do a stress test – or anything else actually. Please, would any doctor here be able to review her files and suggest what we do from here? Thank you so much!
Hi dr I’m 35 year old woman and suffer from sinus tachycardia for last 3 years came on suddenly one day I take bisoprizol every day. I’ve been having left chest pain through to my back sudden drops in bp palpatations sudden nasua dizzyness and forgetfulness like a brain fog I will often get flutters and odd sensations from my heart and any type of excersie leaves me with bad fatigue and chest pain had echo ct scan mri all fine got a loop recorder in and palpatations always in sinus rhythm even had an abdominal ultrasound and endoscopy to make sure it’s not non cardiac pain everytime I’m admitted to hospital I’m told there’s been no heart damage but a recent echo now shows mild tricuspad regurgitation should I be concerned at all I don’t drink or smoke or take any drugs I’m 5-7 and 12 stone I’m worried maybe these daily palpatations are causing last damage
Thank you for your time
The mild tricuspid regurgitation is likely of no significance and no concern.
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My Son id 8 years old and he had a heart surgery and DDDR pacemaker implanted 4 years back and last week we had visited hospital for a period check and in the ECHO report i had seen below parameter for right ventricle. Is it a worrying factor?
Right Ventricle : TAPSE-17mm.
I recently had a stress test and an echo done and my cardiologist said the stress test came back normal but that my echo everything was good except for a moderate leak in the tricuspid valve which he said is abnormal for a 24 year old female. I’m so worried and am wearing an event monitor for 2 weeks and then I go back so he can explain more. If my heart is good except for that finding, should I be concerned?
Moderate tricuspid regurgitation itself needs to be watched only. Its critical to have the leak assessed both quantitatively and qualitatively and dimensions assessed so the true severity can be determined and the readings compared over time. The first thing to do is ask the reading physician to be sure of the severity.
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Hi there I am 47 year old woman with symptoms of chest pain fatigue and tingling right fingers . I had an echo that said I have mild aortic sclerosis , some calcium found in mitral valve, moderate tricuspid valve regurgitation and sinus bradycardia.
Does this mean I have heart disease?
Your heart is not normal entirely however your findings may not be dangerous and need to be discussed with your treating dr in the context of your symptoms.
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hello i am 33 athletic guy .
recently i felt discomfort in the area of the heard and i though its from the heart .
I visited a heart doctor and we did the ultrasound and everything was ok ..just trace mitral tricuspid regurigation and the doctor told me all people have that . Then i felt kind of ok and relaxed . The doctor told me the pain is due to workout on the chest muscle .
every now and then i get this pain or more to say discomfort which is unexplainable .
to be honest i am always stressed and my mind has been under constant stress for long time and i am afraid that could be the reason but i keep getting this discomfort in the heart area .
sometime when i sleep my laptops and phones are next to me .
i mentioned all the reasons and i need advice what should i do ?
The doctor told me to visit a primiary care physcian for an un heart related problem .
please advice
Hi doctor, have a question I have an echocardiogram report with. Mild RV dilation, normalLVEF 55% , trace AR , Mild MR , the pulmonic valve is poorly seen My cardiologist said that my results are normal so I have two questions , the first one is , if everything is normal what is all this finds and if all this needs to be treated and the second one is I am 8 weeks postpartum any of this finds could be because of the pregnancy and if is because of the pregnancy can go away with out any treatment, thank you for your time
Hi doctor, have a question I have an echocardiogram report with. Mild RV dilation, normalLVEF 55% , trace AR , Mild MR , the pulmonic valve is poorly seen My cardiologist said that my results are normal so I have two questions , the first one is , if everything is normal what is all this finds and if all this needs to be treated and the second one is I am 8 weeks postpartum any of this finds could be because of the pregnancy and if is because of the pregnancy can go away with out any treatment, thank you for your time
I have a question: I had an echo because I faint every so often, and the only thing out of the ordinary in my results were an interatrial septal aneurysm and “moderate tricuspid regurgitation with a pulmonary artery pressure at the upper limits of normal.” It’s going to be ages until I see my cardiologist and I am just wondering if either of these could be the cause.
A more comprehensive evaluation is needed, but those things in isolation should not lead to fainting spells.
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Im not sure if this site is still up.to date or if im just typing this for nothing but im reaching out anywhere i can for opinions and help. Here is my story……….
In March of 2011 i thought i was getting the flu as to i was doing alot of outside in the rain kimd of construction work. Plumbing,roofing,windows etc… And also to be totally honest i was a 12 year iv herion drug addict. So first week of april 2011 i was the sickest i ever felt and not because of drugs. I was throwing up. Had pain all over my body and hot fever with cold sweats.. I woke up and felt like someone was sitting on my chest. I called 911.. They found my heart valve was getting stuck open and my nody couldnt handle it. They rushed me to the hospital.. 24 hours and all they knew is that i was a drug addict and was in pain. Finally they transferred me to their main hospital where after 3 days figured out i had a infections on mu tricuspid valve and my lungs and my right knee and right foot. So the heart surgeon came to my room shut the door and sat down and told me i was going to die and try to get my affairs in order. He would try to do a valve transplant but i had to commit that i would never touch drugs again. And he would give me methadone to help with my detox. So i said yes and wanted to live.. It was a friday night. My.brother came to visit me and i remeber talking to him and feeling cold then shivering then like body tremors. I was going into septic shock. They did emergency valve transplant surgery that night. I woke up in icu and started coming back to life. I did a 40 iv antibiotics push and it killed the infection. So i stayed on Methodone and been clean and sobor ever since. 7 years clean. So December of 2015 i was feeling exhusted more then usally and got my ehco and found out that my tricuspid replacement valve was starting to fail. It was a pig valve. I did a week of heprin iv and didnt work. I was gaining 2 to 3 lbs of water a night. For December to February i gained abot 80 pounds of water weight. So Dec 23 2015 i had a valvopastic where the streched the first replacement valve. It didnt help. Finally in fwb 2016 the said i had to have a second valve transplant. This time it was going to be a cow valve. Febuary 16th i had the sugery. For three days my heart went into total heart blockage and hyperoxy. I couldnt breath on my own. My wife approved for them to try a pacemacker to help my heart start again on its own and it did. Finally i was back breathing and heart beating normal again. The only problem was i had no idea where i was or what day or year it was or how old my own kids where. They said i just sat there and moaned and rocked.. Finally at 2:47 am i remember everything my mind finally caught up… I thought it was the next day after my sugery..here it was 5 days later… Crazy.. I was in icu for a week then the heart floor then went home with home nurse and oxygen help. So 2 years later to present.. I havent lost any water weight. I take 160 mgs of lasiks twice a day until my kidneys cant adjust then i stop and 3 day later i start taking them again.. I have begged my doctors… Cardiologist to help they blame it on pulmonary issues with my copd and empazima issues. Then pulmonary says its cardiologist issues.. Still they do test and im still the same… I cant take the weight anymore.. My knees buckle i cant do stairs at all i cant walk more then a block before taking a rest and i cant lay flat to sleep. I dont know what else to do. I want a quality of life not so my a quantity like this. This 330 lb person that only eats good meal twice a day misses the 250 to 270 the biggest i ever been. What should i do now…??? Any help or opinion would be greatly appreciated.
What was the last echo report on the valve?
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The ehco showed alot of water with good heart funtion the valve looked like a little reguardtion building on the replaced valve and option for another valvopastic streching might help.. Its just seems like a revolving door and same things done same.test done.and many same procedures….i need a different outcome and need to loose this water weight. My legs now weep water out of pores and cant wear boots because of such a size difference now.. Just feels like im walking in hip boots filled with water..just dragging it… What should i do next??
Hi Dr Mustafa.
I am 30 years old.
I recently had and echo and showed pulmonary valve stenosis with peak gradients 22 mmHg
Everything else showed up normal.
Is this something to be worried about?
It will need following over time.
Im a 32 yr old female that recently had Acute pericarditis with Tamponade, no trauma, unknown reason.. had to have pericardiocentesis .. the follow up echo shows that I have Trivial mitral regurgitation and moderate tricuspid regurgitation. Could this be caused by the Tamponade, or the pericadiocentesis itself? How should I proceed?
Its not likely related to either of those factors. The mitral disease is essentially normal. The tricuspid needs to be watched over time.
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Mom who had undergone mitral valve replacement 20 yrs ago is diagnosed with severe PAH and mild TR. Doctor has suggested to repair valve after bringing down the PAH , but symptoms of TR are more, like swelling in legs and stomach, no taste for food tiredness etc even after consuming dieurutics.why are these symptoms so severe even for mild TR
What was the valve to be repaired? Mild TR would never need repairing.
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Hi doc im 32 yrs old last time i undergo 24 hr ecg and 2Decho. My ecg was normal including my xray. 2Decho results show mild TR. but sometimes at night time i feel shortness of breath. Is this related to my Mild TR?! I taken med losartan with Hydrochlorothiazide and Bisoprolol concore. Do i have to worry about the shortness of breath this is occasionall. Thank you
This is unlikely related to mild TR.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Im 24yo female with hx of childhood asthma. 2yrs ago i started to feel palpitations and or flutters from my chest to my throat and light SOB. Went to see a cardiologist, when auscultation was performed he just heard a benign murmur (Dont remember if it was systolic or diastolic). Ordered EKG, echo, holter monitor and blood work to check my thyroid function. Everything came back normal although im still getting the palpitations and flutters. Today i got my records and saw in the Echo report impressions Incomplete Tricuspid Regurgition Jet. The Dr said to f/u with him which i never did. I am wondering if i should have.
Best,
Hello Dr. Ahmed, Thank you so much for this site. My mother is 75 suffering from Afib, CHF and Pulmonary Hypertension. I am trying to find out if she is a good candidate for tricupsid valve repair. She is very overweight but has no issue with cholesterol or blockages. She was initially diagnosed with Afib earlier this decade (~2011), before developing CHF at some point perhaps/likely as a result of the afib and/or severe Tricupsid valve Regurgitation. Her cardiologist never gave her the option of ablation early on for the Afib (only unsuccessful cardio-versions), nor mentioned surgery for the Tricupsid valve Regurgitation once that developed. She is suffering from SOB every night trying to sleep and when walking, severe fatigue during the day, and now developing urinary incontinence related to SOB, abdominal pressure, strange sensations. On 40 mg Torsemide, a beta blocker, and blood thinner. BUN, Creatinine, and eGFR have been elevated on current medication regimen as well as. NT-PROBNP up to 3,340.0 pg/mL in July up from 1,100 February during hospital stay. Here is some info from recent Echocardiogram:
DECEMBER 2018: Severely dilated left atrium. Severely dilated right atrium.. Dynamic
inter-atrial septum. Normal left ventricular size, wall thickness and systolic function with estimated ejection fraction 60-65%. Transmitral and tissue Doppler indices are indeterminate to assess diastolic function. Moderately dilated right ventricle with mild global hypokinesis.
Normal aortic root and ascending aorta dimensions. There is no evidence of coarctation of the aortic arch. The aortic valve is trileaflet with mild thickening and calcification. There is no aortic stenosis or aortic regurgitation. Mildly thickened mitral valve with mild mitral regurgitation. No mitral valve prolapse. Trace pulmonic regurgitation. There is moderate to severe tricuspid regurgitation that begins above the plane of the valve suggesting restriction of the valve leaflets by the dilated ventricle. Estimated pulmonary artery pressure is normal at 22 mmHg plus CVP but may be underestimated in the setting of moderate to severe tricuspid regurgitation and elevated right atrial pressures. No pericardial effusion.
2.28.19 (Hospitalized w/ hyperkalemia due to bad medication reaction) – This is a limited echocardiogram. Limited images are obtained. There is severe biatrial enlargement. The left ventricular size and function both appear normal on somewhat limited imaging. The right ventricle appears moderately dilated measuring 5.0 cm at the base and moderately hypokinetic. The aortic valve is mildly thickened and calcified without significant stenosis or regurgitation. The mitral valve is mildly thickened with mild mitral regurgitation. There is moderate to severe tricuspid regurgitation. Pulmonary artery systolic pressure is estimated at 29 mmHg plus central venous pressure. There is no pericardial effusion. The central venous pressure is likely elevated given a dilated, hypocontractile inferior vena cava.
Any suggestions would be extremely appreciated by her family. Her cardiologist said they don’t typically perform such a surgery for women in mid 70’s, but I feel she should have been given the option especially given declining quality of life and her desire to live longer. Both parents lived til mid 90’s including mother with Afib/overweight, and she had an aunt live to 101. I saw your comment earlier that such a surgery was performed on a woman in her 90’s. Thank you again.
Hello,
I am a 22 year old female. I have been experiencing shortness of breath and palpitations since 2017 and have been having constant visits to my primary physician. on February of 2019 I had her refer me to have an echocardiogram done. she told me that my finding came normal, and that I have a mild tricuspid regurgitation. My ejection fraction is 58% and my fractional shortening is 30%. I have an estimates PA pressure of 23mmHg with an assumed right atrial pressure of 3 mmHg. In the reading, the left ventricle is in normal size and has normal systolic function. Despite all of this I have a pulsing sensation on my right neck, especially when I bend or lean down is become physically prominent. I am always fatigued and feel lightheaded and have a whole body sensation of heat (but this comes and goes). I feel shaky and lightheaded after working out, but after a moment of rest it goes away.
does Mild tricuspid regurgitation go away on its own? stay the same? or get worse with time?
should I have another echocardiogram done? and are my symptoms something I should worry about (my doctor said that I have an anxiety disorder and that my heart is healthy).
In general i would not worry at all about mild isolated tricuspid regurgitation picked up on a routine echo.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
In November of 2019 I suffered bad complications after surgery. I ended up with multiple abdominal abscess and C.diff. Because I was experiencing shortness of breath, they did an echo of my heart. It showed moderate tricuspid regurgitation and dilation of the right side of my heart. A previous echo done during pregnancy showed my heart was completely normal.
I am know getting frequent episodes of dizziness and fainting. I also have chronic anemia and hypothyroidism, which could also contribute. It’s a month before I can see a cardiologist. How concerned should I be?
hello, I am very concerned here, I was never told I also have mild-moderate tricuspid regurgitation, I only knew about the mitral valve prolapse with mild regurgitation, and I am freaking out. I have kids that need me more than anything.
I would like to know the likelihood of progression for both, since it is hard to find reliable information that consistently matched other studies.
What is my life expectancy with these two valve issues?
What is the progression timeline?
Since I do not yet have a cardiologist where i live and this echo was done 7 years ago, I am waiting on my first appt with a new cardiologist( my old one passed away) and I want to get a new echo, but until then, I am terrified, no research really gives a good insight of progression timeline. I want to be here for my kids as long as possible. I am a 40-year-old female.
ECHO RESULTS 2014:
Left ventricle is of normal size and dimension, appeared to contract normally. Ejection fraction 60-65%
Diastolic parameters are normal
Right ventricle is of normal size, appears to contract normally.
Right atrium and left atrium of normal size and dimension
Mitral valve appears to open normally. There is mild mitral valve prolapse with mild regurgitation by color -doppler flow
Aortic valve is a trileaflet appears to open normally. No regurgitation noted.
Tricuspid valve opens normally. There is mild to moderate tricuspid regurgitation by color- flow doppler.
Pulmonic valve is normal.
Pericardium is normal.
Aortic is normal.
There are no intracardiac masses noted.
I am An otherwise healthy 34 year old. My tricuspid
Regurgitation was randomly found during an EKG a few years ago- bc I had Tachycardia one night (not recurring) and they ran many tests due to that . Found mild-moderate tricuspid regurgitation. I get heart palpitations sometimes. Flash toward years later, another EKG was done due to another Random
Hospital visit (due to migraine and pregnancy) and I’m
Again told that my regurg is mild-moderate but this time with a pericardial effusion. I’m positive I wont See 40 or my children grow up. Thoughts on why my regurg is so bad and if it will kill me? Soon?
Had an echo done these are the results
-Mitral Valve The leaflets are mildly thickened. The posterior leaflet is mildly prolapsed. There is mild
regurgitation. There is no evidence of mitral valve stenosis.
-Tricuspid Valve Tricuspid valve structure is normal. There is mild to moderate regurgitation. There is no
evidence of tricuspid valve stenosis. The right ventricular systolic pressure is normal. The RVSP
is estimated at 26 mmHg.
-Pulmonic Valve There is trace pulmonic valve regurgitation. There is no evidence of pulmonic valve stenosis.
I’m 49 and a half and I have a trivial tricuspid regurgitation, should I be worried? I don’t want to wait til the last minute to get worse when I’m older and then do something about it.
Not a concerning finding.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.