Tricuspid valve stenosis (TS), or narrowing of the tricuspid valve, does not occur as an isolated lesion and is typically associated with mitral valve stenosis (MS). It is typically associated with rheumatic heart disease and is more common in women than men. Other causes of tricuspid stenosis include congenital tricuspid stenosis.
Symptoms of TS are initially attributed to MS, as this lesion typically develops first. Most patients initially present with pulmonary congestion and fatigue. As TS progresses, patients develop hepatomegaly, ascites, and peripheral edema with fatigue secondary to low cardiac output state.
Physical examination reveals hepatomegaly, jaundice, evidence of malnutrition, distended jugular veins, and hepatojugular reflex. Auscultation may reveal tricuspid valve opening snap following pulmonic valve closure with a diastolic murmur best heard at the lower left sternal border and xiphoid process and is increased with inspiration and decreased with valsalva maneuver or expiration.