Other causes of TR include inferior myocardial infarction (MI), heart failure secondary to rheumatic heart disease, heart failure secondary to congenital heart disease with severe pulmonary artery hypertension, ischemic cardiomyopathy (see coronary artery disease), idiopathic dilated cardiomyopathy, infarction of the RV papillary muscles, tricuspid valve prolapse, infective endocarditis, radiation, endomyocardial fibrosis, or leaflet trauma. The most commonly associated congenital heart disease occurs with Ebstein malformation of the tricuspid valve.
Symptoms of TR include exertional dyspnea, fatigue, abdominal fullness, decreased appetite, lower extremity edema, and progressive weight gain. Physical examination reveals prominent c-v waves with rapid y descents, hepatomegaly with hepatojugular reflex, ascites, pleural effusions, peripheral edema, and a blowing holosystolic murmur along the lower left sternal border, typically with atrial fibrillation.
I36.1 – Nonrheumatic tricuspid (valve) insufficiency
111287006 – Tricuspid valve regurgitation
Differential Diagnosis & Pitfalls