Tricuspid regurgitation is not defined what it means. Tricuspid regurgitation: causes, symptoms, diagnosis, treatment. Causes and signs of mitral regurgitation

By tricuspid regurgitation we mean in which the flow of blood from the ventricle of the right chamber returns to the atrium in the so-called systolic state. The main cause of this disorder is considered to be insufficiently tight closure of the valve flaps. It is useful to be aware of the possible degrees of development of such a disease, the symptoms that appear in children and adults, accepted in modern medical practice measures to eliminate the disease.

How the disease develops

There are two main types of valve regurgitation: acquired over time and.

Reasons congenital form can be called:

• anatomically incorrect number of valve leaflets
• Marfan disease, Ehlers-Danlos disease and some others
• fusion of several valves
• the process of development of connective tissues does not proceed correctly

An isolated such disease can develop only in rare cases. For the most part, the disorder begins to manifest itself as a result of the development of other diseases. Such dysfunctions can occur simultaneously with malformations of the aortic, tricuspid and mitral valves.

The formation of an acquired defect can be influenced by the following factors:

1. Primary stage: development of rheumatism, alcohol and drug abuse. Rheumatism is considered the main cause of the development of this pathology. Approximately 25% of all famous examples The development of the disease is related to rheumatism of endocarditis, in which the tendon threads, as well as the leaflets, undergo gradual deformation.
2. Secondary degree: stenosis of the orifice is formed between the right atrium and the ventricular area, ruptures in the fibers of the papillary muscles, as well as carcinoid syndrome, are possible.

The disease often develops against the background of various gastrointestinal tract And reproductive system. A very common example of diagnosing infective endocarditis is the use of heavy, potent drugs.

The lifestyle of the patient or parents of a newborn with a diagnosed pathology has a significant impact on the development of the disease.

How is the disease classified?

In medical practice, four main degrees of tricuspid regurgitation are known:

1. The return of blood flow is carried out in a minimal volume. The clinic is not monitored, so not a single patient has ever experienced discomfort in such a situation.
2. The return of blood flow is performed within a range of several centimeters from the inner walls. There are also no signs of the development of the disease, however, an increase in pulse rate in the area of ​​the jugular veins may indicate this disorder.
3. At this stage of the disease, blood flow is released beyond 2 cm in the valve. The patient feels a powerful pulsation in the neck area, a noticeably rapid heartbeat, sweetness throughout the body, worsening general well-being and decreased activity even with minor physical activity. Shortness of breath often occurs.
4. Blood flows back through the valve into the right atrium. The patient's general condition may worsen, his health may deteriorate, heart failure may develop, swelling in the legs may appear, pulmonary hyperplasia may be observed, the heartbeat will increase, and the sensitivity of tactile sensations in the limbs will decrease. In such a situation, the liver often increases in size, ascites is diagnosed, and the stomach hurts.

Read also:

How long do people with heart defects live - prognosis for pathologies

We can conclude that in the first two stages of the disease, patients may not notice changes in their own body at all, but the transition to the third stage of the disease immediately noticeably changes their normal lifestyle. For this reason, cardiologists advise everyone to undergo medical examination annually to prevent the subsequent development of the disease if it is detected.

Symptoms

TO clinical signs regurgitation of the tricuspid valve of the first stage can be attributed to a certain list of weak severe symptoms:

• enlarged blood vessels in the neck area
• excessive fatigue
• limbs
• dyspnea
• feeling your own heartbeat

If we consider the example of the manifestation of the disease in newborns, in 20% of cases the symptoms that appear can influence the erroneous diagnosis of tachycardia.

Over time, tricuspid regurgitation develops into heart failure. Feelings of nausea and vomiting may systematically occur, as well. Swelling, enlargement of the liver, accumulation of fluid in the pleural compartment are characteristic in most cases of severe stages diseases.

Symptoms in adults appear depending on the onset of the disease. For example, if regurgitation begins to develop in adulthood, then the presence of the disease can only be known after receiving the results of the autopsy, since nothing indicated its presence.

In most cases, first-degree regurgitation does not have any special signs, but is diagnosed after considering the results of the examination if there is suspicion of some other disease. Therefore, when during clinical examination This particular disease is determined, the patient must be registered and constantly monitored.

Diagnostic methods

Pathology heart valve can be determined during echocardiography and electrocardiography procedures. As additional option A chest x-ray is used. But, regardless of the effectiveness of the methods used, the most informative can be considered of cardio-vascular system. With this option, obtaining the most accurate data is guaranteed. With the help of ultrasound, it becomes possible to assess the condition of all cavities of the heart, as well as tricuspid valve.

During the ECG procedure, the symptoms of the disease can be determined by the increased size of the right ventricle. The disease of the first stage can be determined solely by chance.

However, the transition to the next step already makes it possible to determine using X-rays very specific signs of regurgitation, an increase in the size of the right atrium.

Read also:

Atherosclerosis of the aorta coronary arteries: causes, symptoms and treatment of this disease

In some situations, a catheter is used to obtain detailed results. This kind of approach will be needed to analyze the functionality of the heart valve and in most cases is used before surgery. Naturally, the disease can be diagnosed by considering the patient’s specific complaints, listening to noise and the tone of the heartbeat. During auscultation, the attending physician has the opportunity to determine changes in 1st and 2nd heart sounds.

Technical means used in modern medicine, make it possible to diagnose tricuspid regurgitation without much difficulty.

Treatment and prevention

First of all, therapeutic and preventive procedures carried out after diagnosed regurgitation imply neutralization of the underlying disorder, as a result of which the heart valve was damaged. Such diseases include:

• rheumatism
• heart failure
• infective endocarditis, etc.

If the first degree of the disease does not affect hemodynamics, in most cases no treatment is carried out. In other situations, you will need to use medications and perform the following steps:

1. Elimination of the underlying disease.
2. Stabilization of the blood supply system.
3. Treatment of arrhythmia and heart failure.

Drug treatment includes the use of the following drugs:

• glycosides
• nitrates
• inhibitors
• medicines based

Each drug recommended by a doctor is sold in pharmacy kiosks only after a prescription is provided. The dosage and course of treatment are determined after a comprehensive examination, taking into account specific physiological characteristics the patient's body. Treatment of complex regurgitation is performed in combination with radical and conventional measures. Traditional measures include the use of glycoside drugs and diuretics. The regime implies the use large quantity fluids and avoidance of salty foods.

Surgery is used in situations where the form of the disease reaches moderate or severe. An indicator for the need for surgery is considered to be disruption of the mitral valve caused by pulmonary hyperplasia.

In most cases, surgeons perform annuloplasty, which involves replacing the fibrous ring of the heart valve. Porcine biomaterials, which imitate human tissue to the greatest extent, are often used as prosthetics.

Some heart pathologies do not manifest themselves in any way and do not interfere with a person’s life full life. One of them is dysfunction of the tricuspid valve. Tricuspid regurgitation of the 1st degree is the initial stage of valvular dysfunction that does not require specific treatment. But the person’s condition should be monitored by an experienced cardiologist.

general information

In cardiological practice, the complex term “tricuspid regurgitation” is usually used to describe a condition in which a change in blood flow occurs in the opposite direction. That is, blood is pumped from one chamber of the heart to another. The culprit for what is happening is the tricuspid (three-leaf) valve, which loses the ability to fully close the leaflets.

Grade 1 tricuspid valve regurgitation is not a diagnosis, but a consequence of other disorders in the body. Therefore, you can get rid of it only by curing the underlying disease.

The disease is divided into several types:

• congenital, which is diagnosed in a fetus or a born child in the first months of life;
• acquired, discovered already in adulthood;
• primary, developing against the background of cardiac pathologies;
• secondary, occurring against the background of lung disease.

The disease is also classified based on the stage (degree) of development:

• 1 - characterized by the return of an insignificant blood flow from the ventricle to the atrium and does not require treatment;
• 2 - diagnosed when the jet length is 2 cm and requires specialized treatment;
• 3 - characterized by an increase in flow length of more than 2 cm;
• 4 - diagnosed if the length of the stream exceeds 3 cm.

What factors contribute to the development of the disease?

All factors contributing to the development of tricuspid regurgitation are divided into two large groups. Primary tricuspid regurgitation develops against the background of the following diseases:

• rheumatic heart disease;
• infective endocarditis;
• sagging valve flaps;
• genetic lesion connective tissue;
• congenital displacement or absence of valve leaflets;
• severe damage chest;
• long-term use of certain medicines.

The following pathologies contribute to the development of secondary tricuspid regurgitation:

• increased pressure in the arteries supplying the lungs, or their obstruction;
• enlargement or dysfunction of the right ventricle;
• narrowing of the mitral valve;
• congenital defect of the septum located between the right ventricle and the atrium.

Causes of congenital anomaly

The congenital form of the disease is very rare. More often it develops against the background of other cardiac disorders. The function of the tricuspid valve in the fetus may be impaired due to the following pathologies:

• underdevelopment of valve leaflets;
• congenital increase or decrease in the number of valves;
• disruption of connective tissue development;
• chromosomal disorders.

Grade 1 tricuspid valve regurgitation most often occurs in children with chromosomal abnormalities. It often appears after birth. The initial stage of tricuspid valve regurgitation is considered normal in the absence of other heart pathologies. With age, the valve's function is restored on its own without specific treatment.

Signs of the initial stage of the disease

An experienced cardiologist can recognize the first degree of regurgitation even in the absence of complaints from the patient. And it is determined by palpation of the jugular veins, which are located on the neck. It is enough to put your hand on your neck to feel an unnaturally strong pulsation. As the disease progresses, the following signs appear:

• audible gurgling in the veins of the neck;
• bluish skin color, mainly on the face;
• swelling lower limbs;
• atrial fibrillation;
• disturbance of the heartbeat, audible during auscultation;
• increased heart murmur on inspiration;
• increased fatigue and shortness of breath;
• liver enlargement and accompanying discomfort in the right hypochondrium.

Methods of treatment and prevention

The first degree of regurgitation does not require treatment. After its diagnosis, the patient only needs to systematically visit a cardiologist. In other cases, two types of treatment are used:

• medicinal;
• surgical.

In the presence of cardiac or pulmonary pathologies, therapeutic measures, contributing to their elimination. When diagnosing the second degree of tricuspid valve regurgitation, the patient is prescribed the following groups drugs:

• diuretics;
• means aimed at relaxing vascular muscles;
• preparations containing potassium, etc.

Surgical treatment involves the use of one of several types of surgical intervention:

• installation of the support ring;
• excision of the tricuspid valve;
• removal of the valve followed by installation of a prosthesis.

What are the dangers of lack of treatment?

The initial stage of dysfunction of the tricuspid valve does not threaten the patient’s life. But the disease cannot be left to chance, as it can progress. Particularly dangerous secondary form tricuspid regurgitation. Failure to provide assistance causes fatal outcome, occurring from progressive heart failure and myocardial infarction.

Video: Tricuspid valve insufficiency

Tricuspid valve regurgitation is a condition in which, during contraction (systole) of the ventricles, blood is refluxed from the RV (right ventricle) into the RA (right atrium), which occurs due to incompetence of the tricuspid valve. Thus, the term “regurgitation” means reverse, abnormal blood flow (you can read more about regurgitation in our article on).

Sometimes such a pathology is discovered on cardiac ultrasound completely by accident, most often it is physiological or valvular regurgitation. In this case, patients are concerned with the question “grade 1 tricuspid regurgitation, what is it?” This and other questions can be answered by reading the article, which will discuss in more detail the types, causes, manifestations of pathology, as well as its identification and treatment.

Classification

According to degrees, it is customary to distinguish four types of TR (tricuspid regurgitation):

1. Stage one – the reverse flow of blood is almost not visualized, the patient does not feel any changes;
2. Degree two - blood flow in the opposite direction is observed at a distance of no more than 2 cm from the valve leaflets.
3. Stage three - the reverse flow of blood into the RA (right atrium) is determined further than at a distance of 2 cm from the valve, the stream is clearly visualized;
4. Degree four - reflux of blood in the wrong direction is noticeable at a considerable distance from the tricuspid valve.

In addition, there are two types of regurgitation on the TC:

1. Primary – as a manifestation of organic pathology of the heart, often combined with other heart defects and lesions of the valve apparatus. IN in this case Only the right side of the heart is involved, and pulmonary hypertension is not common.
2. Secondary - this type occurs against the background existing diseases heart and is always accompanied by hypertrophy and increased function right ventricle and

Causes

A great variety of causative factors can be divided into those that lead to primary tricuspid regurgitation and those that cause secondary tricuspid regurgitation.
Common causes of primary tricuspid regurgitation are:

• Rheumatic diseases (including acute rheumatic fever, rheumatoid arthritis, etc.);
• Endocarditis of infectious nature ( inflammatory process inner layer of the heart);
• TC prolapse;
• Right ventricular infarction;
• Carcinoid syndrome (deposition of connective tissue plaques on valves, in the wall of the heart muscle and large vessels);
• Marfan syndrome;
• Epstein's vice;
• The use of certain medications (phentermine, ergotamine, fenfluramine).

Causes of secondary regurgitation on the TC:

• Hypertrophic changes in the right ventricle;
• Pulmonary hypertension;
• Cardiomyopathy;
• Enlargement (dilatation) of the right ventricle.

Among all the above factors, this pathology most often occurs with dilatation of the right ventricle and increased pressure on the pulmonary artery.

Symptoms

If a patient has grade 1 tricuspid regurgitation, he will usually feel nothing subjectively. The general condition does not suffer in any way.
Such changes are often detected only randomly during cardiac ultrasound.

This condition also does not require treatment in most cases. The exception is cases when the underlying causative disease is identified, which led to the initial changes in the valve.

In this case, therapy will be aimed at curing the underlying disease.
If tricuspid regurgitation of grade 2 or higher has developed, the disease can also pass without obvious symptoms and not worsen the patient’s quality of life.
However, if the condition has developed acutely or is severe, the following complaints may appear:

• increased fatigue due to the development of heart failure;
• bulging of the jugular veins in the neck, a feeling of their increased pulsation - is associated with an increase in the level of pressure in the veins;
• pain in the area under the ribs on the right (liver projection), its increase beyond the costal arch - due to congestion in big circle blood circulation;
• swelling of the legs;
• dyspnea;
• coldness of the extremities – associated with insufficient blood supply to the arms and legs;
• interruptions in myocardial function.

Objectively, through auscultation, the doctor can identify:

• systolic murmur to the left of the sternum in the 5th intercostal space, which will be better heard when inhaling;
• percussion with a significant increase in the right atrium and ventricle, the boundaries of the relative dullness of the heart will be expanded accordingly to the right.

Diagnostics

The diagnosis of regurgitation on the tricuspid valve is made by a cardiologist or therapist.

If we are talking about TR of the 1st degree, then it is often diagnosed only on the basis of an instrumental examination, namely, echocardiography, which is performed for some other purpose.

In other cases, the diagnosis can be made based on:

• Set of patient complaints
• Examining the patient, listening to heart sounds and identifying murmurs
• Electrocardiography. In this case, signs of overload of the right parts of the heart will be observed, namely: increased amplitude and sharpened beat. R, increased z. R in chest leads, corresponding to the right parts of the heart (V1, V2, V3), as complications of the main pathology
• Ultrasound of the heart with Doppler. Allows you to identify structural changes heart (the thickness of the myocardium of the right ventricle, the size of the cavity of the right atrium, etc.) and the length of the stream of back-absorbed blood, on the basis of which the degree of TR is set: one, two, three or four. In addition, it is possible to determine the pressure gradient on the TC (normally< 25 мм.рт.ст.) и скорость потока (в норме менее 2,5 м/с)
• Radiography. A chest X-ray is taken. With minor regurgitation, no changes are usually observed. In more severe cases signs such as an increase in the shadow of the superior vena cava (SVC), expansion of the shadow from the right atrium and the ventricle of the same name may appear. In addition, if complications develop, an x-ray will help identify effusion fluid in the pleural cavity
• Cardiac catheterization. The method is invasive and therefore is prescribed extremely rarely. It can be used to detect an increased systolic wave of the atria and measure the pressure in the atria during systole, which will be normal or increased

Tricuspid regurgitation on Echo-CG

Treatment

Tricuspid regurgitation in most cases is a consequence of another pathology, so treatment should initially consist of eliminating the main causative factor.

If the patient has regurgitation on the TC of the 1st degree with feeling good treatment does not need to be carried out, since the hemodynamic disturbances are not significant at all, this reverse flow of blood can be considered physiological.

1. Conservative treatment

Treatment with drugs is usually carried out for stage 2 TR in the presence of circulatory complications: arrhythmia or circulatory failure. The following means are used:

• Diuretics
• Vasodilators
• Antiarrhythmics

With the development of tricuspid regurgitation of degrees 3 and 4, surgical intervention may be required.
General indications:

• Pulmonary hypertension and increased pressure in the RV (right ventricle)
• Combination of TR with severe mitral regurgitation, which manifests itself clinically

1. Surgical treatment and its options

• Annuloplasty. The essence of the operation is that an artificial ring is sutured to the natural valve ring, due to which its diameter can be reduced. It is advisable to carry out this type surgical intervention, if the cause of regurgitation was the expansion of the ring.
• Plastic surgery of the valve apparatus. It is performed in two cases: it is the valve that is primarily affected or it is impossible for some reason to perform annuloplasty.
• Valve replacement. This type of surgical treatment is indicated if the cause of regurgitation is pathologies such as Epstein's disease or carcinoid syndrome. For replacement, a porcine valve is used, which can last in the right side of the heart for 10 years or even more.

A special operation is called valve excision. It is carried out in a single case: with the development of infective endocarditis, the conservative treatment of which has had no effect.

Now it becomes clear what tricuspid regurgitation is and how dangerous it is. Let us emphasize once again that grade 1 of this pathology usually does not cause concern among doctors and does not require therapy. Regurgitation high degrees with severe course can cause serious complications, therefore requiring treatment, including surgery.

When there is incomplete closure of the tricuspid valve. In this condition, the patient experiences reverse blood flow from the right ventricle into the atrium.

The human circulatory system provides one-way blood flow. Blood moves from the ventricle to the atrium in one direction thanks to valves that close tightly with each contraction of the heart. If they are incompletely closed, then some of the blood returns to the ventricle (regurgitation).

The disease is treated by a cardiologist. The choice of treatment method depends on the severity of the pathology. So, 1st degree does not need specific treatment, doctors recommend simply monitoring the patient’s condition. Patients with stage 2 pathology undergo conservative treatment. And at degrees 3 and 4, the functioning of the cardiovascular system can only be restored through surgery.

Causes of the disease

This pathology occurs in two main forms:

1. Primary, the causes of which are the following diseases: rheumatism, endocarditis (acute inflammation of the inner wall of the heart), myocardial infarction, the formation of fibrous plaques in the heart tissue and genetic predisposition.
2. Secondary. Such valve damage is observed due to its stretching during cardiomyopathy and pulmonary hypertension, which increase the functional load on the right ventricle.

Characteristic symptoms

• The presence of visible pulsation of the neck veins.
• Swelling of blood vessels in the left side of the sternum and right hypochondrium.
• Progressive swelling of the soft tissues of the legs.
• Loss of performance and fatigue.
• Frequent feeling of “chilliness”.
• Feeling of rapid heartbeat.
• Frequent urination.
• Shortness of breath, which first bothers the patient during physical activity, and then is diagnosed at rest.
• Periodic attacks of abdominal pain.
• Yellow tint skin, which is combined with painful sensations in the right hypochondrium.

The severity of the above symptoms depends on individual characteristics organism and the degree of damage. For example, a patient diagnosed with tricuspid regurgitation at the initial stage has no pathological symptoms. A pronounced clinical picture is usually observed in phases 3–4 of the disease, when radical intervention is required.

Four degrees of disease

1. Minimal disruption of blood flow, which is completely asymptomatic.
2. The presence of a backflow of blood up to 2 cm long.
3. Regurgitation is more than 2 cm.
4. The disease is accompanied by acute heart failure.

Diagnosis of the disease

Cardiac patients undergo the following diagnostic measures:

• Visually examine the patient and listen to heart sounds using a phonendoscope.
• Ultrasound examination, which allows you to determine the condition of the heart tissue and valve.
• Electrocardiography. Method defines early signs enlargement of the right stomach and atrium.
• X-ray of the chest organs. Such a study determines disturbances in the operation of the valve system.
• Cardiac catheterization is an innovative, minimally invasive procedure used to diagnose and treat cardiac diseases.

Click on photo to enlarge

Treatment methods

In many cases, grade 1–2 tricuspid regurgitation does not require specific therapy in the absence of concomitant pathology internal organs and heart failure.

Treatment of patients in the initial stages is “supportive”; they are given measures to eliminate high blood pressure. The patient should be under the supervision of a cardiologist.

Further progression of heart valve pathology is considered a reason for conservative therapy. Doctors prescribe the following medications to the patient:

• Diuretics. Diuretics for hypertension stimulate the elimination of salts and excess fluid from the body.
• Venous vasodilators. Reducing the tone and increasing the lumen of blood vessels helps lower blood pressure and improve blood circulation.
• ACE inhibitors. The action of the drugs is aimed at inhibiting the function of the enzyme that converts angiotensin, which constricts blood vessels and provokes an increase in blood pressure.
• B-blockers. These medications reduce heart rate, eliminate hypertension and chronic heart failure.
• Cardiac glycosides that have cardiotonic and antiarrhythmic effects.
• Metabolic drugs. Data medicines improve the transport of oxygen to all tissues of the body.
• Anticoagulants as a means of preventing thrombosis.

Tricuspid regurgitation in later stages (3 and 4) is treated surgically.

Surgical intervention

Patients undergo the following operations:

Prognosis for the disease

Tricuspid regurgitation has a favorable prognosis only in the first degree of the disease. Such patients lead a full-fledged lifestyle - the operation of the valve does not change the function of the cardiovascular system.

At the second stage of the disease, patient mortality is associated with concomitant general diseases. These may be: myocardial infarction, chronic heart failure, inflammatory lesion lungs and thromboembolism.

Tricuspid regurgitation at stages 3–4 of the disease is characterized by a poor prognosis. It requires surgery. Medical statistics show that timely valve repair increases the patient’s life expectancy by 5 years or more. At the same time, prosthetics with biological material in 60% of clinical cases extended life expectancy by 15 years.

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Tricuspid valve regurgitation

Tricuspid regurgitation, like many other cardiac pathologies, is rapidly becoming younger today. A malfunction of the heart valve can be detected even before the baby is born, during an ultrasound.

Tricuspid valve regurgitation is often diagnosed in preschool children, and in adults it usually develops against the background serious illnesses of very different nature. This anomaly has several forms, different symptoms and correspondingly, different approaches to treatment.

The concept of tricuspid regurgitation

The term "regurgitation" is medical. It comes from the Latin word gurgitare (translated as “to flood”) and the prefix re-, meaning “again, back.” In cardiology, regurgitation is the reverse flow (reflux) of blood from one chamber of the heart to another.

The heart consists of four chambers (2 atria and 2 ventricles), separated by septa and equipped with four valves. These are the mitral, aortic, pulmonary artery and tricuspid (three-leaf). The latter connects the right ventricle and the right atrium. In each of the valves various reasons Blood flow disturbances may occur, which means there are four types of this disease.

Aortic and mitral regurgitation are most often diagnosed; tricuspid regurgitation is slightly less common. But the danger is that the diagnosis can be confused different shapes this pathology. In addition, sometimes disturbances in the functioning of different heart valves occur simultaneously in a patient.

An important point: tricuspid valve regurgitation is not an independent disease and a separate diagnosis. This condition usually develops due to other serious problems (heart, lung, etc.), and therefore is usually treated in combination. And most importantly, an anomaly with a frightening Latin name should not be considered a death sentence. It is quite easy to diagnose, it is quite possible to cure or at least strictly control it.

Types of tricuspid regurgitation

There are 2 main classifications of this pathology - according to the time of appearance and the reasons for its occurrence.

• By time of appearance: congenital and acquired.

Congenital is registered during the intrauterine development of the child or in the first months after birth. In this case, heart valve function may return to normal over time. In addition, it is much easier to keep a congenital anomaly under control if you take care of the heart and follow measures to prevent cardiovascular diseases.

Acquired disease appears in adults already during life. This pathology almost never occurs in isolation; it can be caused by a variety of diseases - from dilatation (expansion) of the ventricle to obstruction of the pulmonary arteries.

Primary tricuspid anomaly is diagnosed against the background of heart disease. No problems with respiratory system the patient with this diagnosis does not. The main cause of secondary disruption of blood flow in the tricuspid valve is pulmonary hypertension, that is, too high pressure in the pulmonary artery system.

Regurgitation of the tricuspid valve traditionally goes hand in hand with insufficiency of the valve itself. Therefore, some classifications divide the types of reverse blood flow based on the form of tricuspid insufficiency, that is, the valve disease itself:

1. Organic (absolute) failure, when the cause is damage to the valve leaflets due to a congenital disease.
2. Functional (relative), when the valve is stretched due to problems with the pulmonary vessels or diffuse damage to the cardiac tissue.

Degrees of tricuspid valve regurgitation

Regurgitation can occur in 4 various stages(degrees). But sometimes doctors identify a separate, fifth, so-called physiological regurgitation. In this case, there are no changes in the myocardium, all three valve leaflets are completely healthy, there is simply a barely noticeable disturbance in the blood flow at the leaflets themselves (“swirling” of the blood).

• First stage. In this case, the patient experiences a small flow of blood back, from the ventricle into the atrium through the valve leaflets.
• Second stage. The length of the jet from the valve reaches 20 mm. Tricuspid regurgitation of the 2nd degree is already considered a disease that requires special treatment.
• Third stage. Blood flow is easily detected during diagnosis and is greater than 2 cm in length.
• Fourth stage. Here the blood flow already goes a considerable distance deep into the right atrium.

Functional tricuspid regurgitation is usually graded as grade 0–1. Most often it is found in tall, thin people, and some medical sources they report that absolutely 2/3 have such an anomaly healthy people.

This condition is absolutely not life-threatening, does not affect well-being in any way, and is discovered during examination by chance. Unless, of course, it starts to progress.

Causes of pathology

The main cause of impaired blood flow through the tricuspid valve is dilatation of the right ventricle along with valvular insufficiency. This anomaly is provoked by pulmonary hypertension, heart failure, obstruction (obstruction) of the pulmonary arteries. Less commonly, the causes of backflow of blood are infective endocarditis, rheumatism, taking medications, etc.

Factors that cause this to occur heart disease, are usually divided into 2 large groups depending on the type of pathology itself:

1. Causes of primary tricuspid regurgitation:
   • rheumatism (systemic inflammation of connective tissue);
   • infective endocarditis (inflammation of the endocardium, often found in injection drug users);
   • valve prolapse (the valves bend by several millimeters);
   • Marfan syndrome ( hereditary disease connective tissue);
   • Ebstein's anomalies (a congenital defect in which the valve leaflets are displaced or absent);
   • chest injuries;
   • long-term use of medications (Ergotamine, Phentermine, etc.).
2. Causes of secondary tricuspid regurgitation:

• increased pressure in the pulmonary arteries (hypertension);
• enlargement or hypertrophy of the right ventricle;
• right ventricular dysfunction;
• mitral valve stenosis;
• failure of the right and severe failure of the left ventricle;
• various types of cardiopathy;
• atrial septal defect (congenital defect);
• obstruction of the pulmonary artery (and its outflow tract).

Symptoms

In mild forms of impaired blood flow between the chambers of the heart, there are no specific symptoms.

Tricuspid regurgitation of the 1st degree can manifest itself only by one sign - increased pulsation of the veins in the neck.

This effect occurs due to high pressure in the jugular veins, and it is easy to feel the pulsation by simply placing your hand on the right side of the neck.

In later stages, you can feel not only a beating pulse, but also a clear trembling of the neck veins. The following symptoms will indicate problems with blood flow in the right ventricle:

• the jugular veins not only tremble, but also swell noticeably;
• bluish skin color (primarily on the nasolabial triangle, under the nails, on the lips and tip of the nose);
• swelling of the legs;
• atrial fibrillation;
• splitting of heart sounds;
• holosystolic heart murmur (increases with inspiration);
• shortness of breath and fatigue;
• pain and heaviness in the right hypochondrium;
• enlarged liver, etc.

Most of these signs may indicate the most different problems of cardio-vascular system. Therefore, the clearest visible symptom Tricuspid regurgitation is precisely the swelling and trembling of the jugular vein.

Tricuspid regurgitation in children

Reverse reflux of blood into the right ventricle is now increasingly being recorded in children, even before birth. Tricuspid regurgitation in the fetus can appear in the first trimester of pregnancy, at 11–13 weeks.

This feature often occurs in babies with chromosomal abnormalities (for example, Down syndrome). But a certain percentage of regurgitation is also observed in an absolutely healthy fetus.

Pediatric cardiologists report a rapidly growing number of cases of tricuspid anomaly in children different ages. In most of them, regurgitation of the first degree is diagnosed, and today it is already considered a normal variant.

If the child does not have other heart pathologies, in the future there is a high chance that the valve will work on its own.

But if the congenital disease reaches the second or third stage, there is a risk of developing heart failure and right ventricular dysfunction in the future. Therefore, it is important for the child to regularly visit a cardiologist and follow all necessary measures prevention of heart diseases.

Diagnostics

Doctors learned to identify severe tricuspid regurgitation a long time ago, but diagnosing mild forms became possible relatively recently, with the advent of ultrasound. That is about 40 years ago.

Today ultrasonography is considered the main diagnostic method for such pathology. It allows you to distinguish the slightest opening of the valve flaps, the size and direction of the blood stream.

A comprehensive diagnosis of tricuspid valve regurgitation includes the following:

• taking anamnesis;
• physical examination (including cardiac auscultation - listening);
• Ultrasound of the heart (regular and with Doppler) or echocardiography;
• electrocardiography;
• chest x-ray;
• cardiac catheterization.

Catheterization is a diagnostic and therapeutic method that requires careful preparation of the patient. It is rarely used to study problems with blood flow through the tricuspid valve. Only in cases where the maximum is required in-depth diagnostics, for example, to assess the condition coronary vessels hearts.

Treatment and prevention

Therapy for tricuspid regurgitation includes 2 large blocks - conservative and surgical treatment. When the disease is in the first stage, no special therapy is required, only regular monitoring by a cardiologist.

If the patient has cardiovascular pathologies that provoked a disturbance in blood flow, all treatment is aimed specifically at them, that is, at eliminating the cause of regurgitation.

When the disease reaches the second stage, conservative treatment already involves taking special medications. These are diuretics (diuretic), vasodilators (agents for relaxing the muscles of blood vessels), potassium supplements, etc.

Surgical treatment of the tricuspid valve includes the following types of operations:

The prognosis for life with tricuspid regurgitation is quite favorable, provided that the patient follows healthy image life and protects his heart. And when the disease is detected at the very first stage, and when valve surgery has already been performed.

In this case, doctors advise using standard measures to prevent heart failure. These include body weight control and regular physical activity, proper nutrition, giving up cigarettes and alcohol, regular rest and as little stress as possible. And most importantly, constant monitoring by a cardiologist.

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Tricuspid regurgitation 1st degree: what is it, treatment and prevention

Tricuspid regurgitation grade 1, 2 or 3 is a heart defect, congenital or acquired, characterized by backflow of blood into the right atrium from the right ventricle during systole.

The cause of tricuspid regurgitation is loose closure of the tricuspid valve leaflets.

The patient can learn more about what tricuspid regurgitation is at an appointment with a cardiologist or obtain information on our website.

The term regurgitation is translated as backflow; in the case of heart disease, it is the wrong direction of blood flow.

Main causes of violation

Tricuspid regurgitation can be caused by:

• congenital anomalies of the tricuspid valve;
• Ehlers-Danlos syndrome;
• Ebstein's anomaly;
• Morphan's syndrome.

Isolated defects in the fetus occur infrequently; most defects are of a combined nature.

The acquired form of the disorder is more common than the congenital form.

The cause of the acquired pathology may be:

Most often, the disease is caused by rheumatic endocarditis, which deforms the tricuspid valve leaflets and tendons.

In some cases, a narrowing of the opening of the right ventricle is added to the change in the structure and shape of the valve, forming a combined tricuspid defect.

Injury to the papillary muscles during myocardial infarction can also lead to tricuspid defect.

Some serious illnesses(carcinoid syndrome) can lead to disruption of the closure of the valve leaflets and reverse blood flow. Such diseases include:

Classification and main symptoms of the disorder

Cardiologists distinguish 4 degrees of impairment, determined by the length of the blood stream and the strength of its flow (whether the reverse flow is thrown at full force or its strength is moderate).

Classification by degree of violation:

• Tricuspid valve regurgitation 1st degree - minimal blood flow.
• Tricuspid regurgitation of the 2nd degree - the jet is thrown no more than two centimeters.
• Tricuspid valve regurgitation grade 3 - blood flow penetrates more than 2 centimeters.
• A grade 4 disorder is characterized by blood penetration into the right atrium of more than three centimeters.

The disorder is characterized by mild symptoms, the severity of symptoms increases with the acute form of regurgitation. Acute form gives right ventricular heart failure and pulmonary hypertension.

• swelling of the neck veins;
• increased pulsation in the left side of the chest, especially when inhaling air;
• pulsating liver;
• swelling;
• constant fatigue;
• dyspnea;
• intolerance to low temperatures;
• frequent urination;

Tricuspid regurgitation of the first degree. Prevention

The first degree of regurgitation is considered physiological state and does not require treatment. The patient needs to undergo necessary examination once a year to avoid complications. The patient must come for control at the time prescribed by the doctor.

Young men are interested in the question: are they recruited into the army with such a problem? In the first degree of valve malfunction, when the refluxed blood flow is no longer than two centimeters, no pathological changes occur. The person is completely healthy and can be taken into the army.

In case of a second degree violation, treatment is prescribed and the person is released from service, since the army lifestyle involves physical activity that is contraindicated for such a diagnosis.

The diagnosis of tricuspid regurgitation must be confirmed by echocardiography, cardiogram, stress test results and other clinical tests.

Persistent arrhythmia, conduction disturbances and severe heart failure lead to dismissal from service.

Patients with this form of the disease are prescribed physical therapy, swimming, race walking, skiing. Sports involving lifting heavy objects are prohibited. The following procedures lead to improvement of the condition: massage, herbal medicine, acupuncture.

Patients are advised to follow necessary diet. It is not recommended to overuse fatty, fried and salty foods. Doctors advise keeping weight under control, as quickly gaining kilograms leads to a sharp deterioration in a person’s condition.

Preventive measures are divided into primary and secondary. Primary activities are carried out for healthy people and include:

• Timely diagnosis and adequate treatment of viral and infectious diseases leading to cardiac dysfunction (rheumatism, infectious endocarditis, influenza).
• Fighting foci of infection in the body ( chronic tonsillitis, caries).
• Hardening children and raising the overall tone of the body.

Secondary preventive measures are intended for patients with diagnosed regurgitation of the second and third degrees, complicated by progressive valve damage.

Secondary preventive measures:

• Drug therapy necessary to strengthen general tone and reduce the risk of complications (diuretics, nitrates, potassium, glycosides, vitamins, immunomodulators).
• Antibiotic therapy.
• Hardening procedures, physiotherapy, physical therapy.
• Removing foci of infection such as tonsils and caries.
• Special diet.

The menu for patients must include lean meat, nuts, bananas, fresh herbs, vegetables and fruits.

Traditional methods of treatment

The disease in the second and third stages requires complex therapy, That's why herbal infusions will only be useful in combination with medications. Treatment should be supervised by a doctor.

To help patients with regurgitation, herbal remedies are used. Hawthorn, thorn and heather are taken in equal proportions. The raw materials are poured with boiling water and kept in a water bath for 15 minutes.

To improve the condition, you can use rosemary infused in wine. For the tincture, take one hundred grams of dried rosemary and two liters of red wine. The mixture should stand for three months in a dark, dry place.

Well relieves symptoms of overexertion nervous system Mint tea, it is recommended to drink it before bed.

Tricuspid regurgitation

Tricuspid regurgitation is one of the types of heart defects in which there is insufficiency of the tricuspid (tricuspid) valve, leading during systole to the reverse flow of blood from the right ventricle into the atrium.

Tricuspid regurgitation: causes

Most often, the development of tricuspid valve regurgitation occurs against the background of heart disease, occurring with dilatation of the right ventricle and pulmonary hypertension. Much less frequently, this disease occurs against the background of septic endocarditis, rheumatism, carcinoid syndrome, and Marfan syndrome. Tricuspid valve insufficiency may be congenital or develop as a result of long-term use certain medications (phentermine, fenfluramine, ergotamine).

Symptoms

With a minor defect of the tricuspid valve leaflets (grade 1 tricuspid regurgitation), the disease usually does not manifest itself in any way and is considered a benign condition for which no treatment is carried out. Only a small proportion of patients experience pulsation of the neck veins caused by increased pressure in them.

In severe tricuspid regurgitation, marked swelling of the jugular veins is observed. Putting your hand to your right jugular vein you can feel it shaking. Significant valve insufficiency can lead to right ventricular dysfunction, atrial flutter, or atrial fibrillation, the formation of heart failure.

Tricuspid regurgitation: diagnosis

It is possible to make the correct diagnosis of tricuspid regurgitation, as well as determine the extent of the disease, based on Doppler echocardiography data. With grade 1 tricuspid regurgitation, the reverse flow of blood from the right ventricle back into the right atrium is barely noticeable. Tricuspid regurgitation of the 2nd degree is characterized by reverse blood flow no more than 2.0 cm from the tricuspid valve. With the third degree of insufficiency, regurgitation exceeds 2.0 cm, and with the fourth, it spreads throughout the entire volume of the right atrium.

As additional methods Studies include ECG and chest x-ray. An electrocardiogram often reveals signs of right ventricular hypertrophy. Radiographs of grade 1 tricuspid regurgitation usually show no changes. With tricuspid regurgitation of grade 2 and higher, an enlarged shadow of the superior vena cava and right atrium is detected, and in some cases, the presence of effusion in the pleural cavity.

Cardiac catheterization as a diagnostic method for tricuspid valve regurgitation is extremely rare.

Mild tricuspid regurgitation is well tolerated by people and does not require treatment. Therapy is usually prescribed for grade 2–4 tricuspid regurgitation. First of all, it is aimed at eliminating the cause that led to the development of tricuspid valve insufficiency (treatment of rheumatism, septic endocarditis, etc.). In addition, complications caused by tricuspid regurgitation - heart failure, arrhythmia - are also treated.

In the absence of effect from conservative treatment, as well as further progression valve insufficiency, surgical intervention is indicated - prosthetics, tricuspid valve repair or anuloplasty.

Anuloplasty is usually used in cases where the disease develops due to dilatation (widening) of the valve ring. Tricuspid valve replacement is indicated for valve insufficiency caused by Epstein's disease or carcinoid syndrome. A porcine valve is used for the prosthesis, which can significantly reduce the likelihood of developing thromboembolic complications in the postoperative period. As practice shows, the pig valve functions effectively for more than 10 years, after which it is replaced with a new one.

Video from YouTube on the topic of the article:

The information is generalized and is provided for informational purposes. At the first signs of illness, consult a doctor. Self-medication is dangerous to health!

I hope you don’t seriously think that the decision about the need for heart surgery is made on the Internet based on a two-sentence description. You need an in-person consultation with a cardiologist.

If you have complaints, you should consult with another cardiologist. It is also advisable to take a blood test to rule out anemia.

And if a child has the flu or a sore throat, will you also send him to an orphanage so that there are no problems? Tricuspid regurgitation of the 1st degree does not pose a serious problem, and in most cases it does not require treatment either. The doctor couldn't say such nonsense.

Good afternoon, Tasya555.

Good afternoon, Tasya555.

Indeed, there is no particular danger, but consultation with a cardiologist is necessary, and periodic examination is also required.

THANK YOU. We are going to see a cardiologist.

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Tricuspid regurgitation

Tricuspid regurgitation (tricuspid valve insufficiency) is a heart defect in which blood flows back in systole through the tricuspid valve from the right ventricle into the cavity of the right atrium.

How does tricuspid valve regurgitation occur?

The tricuspid or tricuspid valve is located between the right atrium and the right ventricle; during diastole, its leaflets open, allowing venous blood from the right atrium to the ventricle. During systole (contraction), the valve leaflets close tightly, and the blood entering the right ventricle enters the pulmonary artery and then into the lungs. When the tricuspid valve regurgitates, the blood from the right ventricle does not completely enter the pulmonary artery, but partially returns to the right atrium, and a reverse reflux of blood occurs - regurgitation. This occurs due to dysfunction of the tricuspid valve - when its valves do not close tightly, the entrance to the right atrium does not completely close. With tricuspid regurgitation, due to increased load, the atrium hypertrophies, and then the muscles stretch and increase in size. In turn, this leads to the entry of a large amount of blood from the atrium into the right ventricle during diastole, its further hypertrophy and dysfunction, which provokes stagnation in the systemic circulation.

Causes and types of tricuspid regurgitation

There are several types of tricuspid valve insufficiency:

• Absolute or organic failure. The pathology is caused by damage to the valve leaflets, such as valve prolapse (sagging leaflets), due to congenital disease– connective tissue dysplasia, also caused by rheumatism, infective endocarditis, carcinoid syndrome and others;
• Relative or functional deficiency. Occurs when the valve is stretched due to resistance to the outflow of blood from the right ventricle, with pronounced dilatation of the ventricular cavity caused by high pulmonary hypertension or diffuse myocardial damage.

Based on the severity of reverse blood flow, tricuspid regurgitation is divided into four degrees:

• 1st degree. Barely detectable backflow of blood;
• 2nd degree. Regurgitation is determined at a distance of 2 cm from the tricuspid valve;
• 3rd degree. Reverse flow of blood from the right ventricle is detected at a distance of more than 2 cm from the valve;
• 4th degree. Regurgitation is characterized by a large extent in the cavity of the right atrium.

The severity of blood return is determined using echocardiographic examination.

Description of grade 1 tricuspid regurgitation

With regurgitation of the 1st degree, as a rule, the symptoms of the disease do not manifest themselves, and it can only be detected accidentally during electrocardiography. In most cases, grade 1 tricuspid regurgitation does not require treatment and can be considered normal. If the development of the disease is provoked by rheumatic defects, pulmonary hypertension or other diseases, it is necessary to treat the underlying disease that caused a minor defect in the tricuspid valve leaflets.

In children, this degree of regurgitation is considered anatomical feature, which may even disappear over time - without the presence of other cardiac pathologies, it usually does not affect the development and general condition of the child.

Symptoms of tricuspid regurgitation

With grade 2 tricuspid regurgitation, as with other degrees, the disease often occurs without obvious symptoms. In severe cases of the disease, the following manifestations are possible:

• Weakness, fatigue;
• Increased venous pressure, leading to swelling of the veins of the neck and their pulsation;
• Enlarged liver with characteristic pain in the right hypochondrium;
• Heart rhythm disturbances;
• Edema of the lower extremities.

Auscultation (listening) reveals a characteristic systolic murmur, best heard in the 5th–7th intercostal space from the left edge of the sternum, intensifying with inspiration, quiet and inconsistent. With enlargement of the right ventricle and a large volume of blood entering it during diastole, a systolic murmur is also heard over the right jugular vein.

Diagnosis of tricuspid regurgitation

To diagnose tricuspid regurgitation, in addition to the history, physical examination and auscultation, the following studies are performed:

• ECG. The dimensions of the right ventricle and atrium, heart rhythm disturbances are determined;
• Phonocardiogram. The presence of systolic murmur is detected;
• Ultrasound of the heart. Signs of compaction of the valve walls, the area of ​​the atrioventricular orifice, and the degree of regurgitation are determined;
• Chest X-ray. The location of the heart and its size, signs of pulmonary hypertension are revealed;
• Catheterization of the heart cavities. The method is based on the introduction of catheters to determine the pressure in the cavities of the heart.

In addition, coronary angiocardiography can be used before surgery. It is based on injection into the vessels and cavities of the heart. contrast agent, to assess the movement of blood flow.

Treatment of tricuspid regurgitation

Treatment of the defect can be carried out conservatively or surgical method. Operative method may be indicated already for grade 2 tricuspid regurgitation, if it is accompanied by heart failure or other pathologies. With functional tricuspid regurgitation, the disease that caused the lesion is treated first.

At drug therapy prescribed: diuretics, vasodilators (drugs that relax the smooth muscles of the walls of blood vessels), potassium supplements, cardiac glycosides. If conservative treatment is ineffective, surgical intervention is prescribed, including plastic surgery or annuloplasty and prosthetics. Plastic surgeries, suture and semicircular annuloplasty are performed in the absence of changes in the valve leaflets and expansion of the fibrous ring to which they are attached. Prosthetics are indicated for tricuspid valve insufficiency and extremely severe changes in its valves; prostheses can be biological or mechanical. Biological prostheses created from animal aortas can function for more than 10 years, then the old valve is replaced with a new one.

With timely treatment of tricuspid regurgitation, the prognosis is favorable. After it is performed, patients must be regularly monitored by a cardiologist and undergo examinations to prevent complications.

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Tricuspid regurgitation is one of the types of heart defects in which a backflow of blood occurs during systole from the right ventricle into the cavity of the right atrium. The reason for this is the incomplete closure of its valves. Tricuspid valve regurgitation can be acquired or congenital.

Origin of the term

The word "regurgitation" comes from the Latin gurgitare - "to flood" - and the prefix re-, denoting a reverse action, i.e. it implies a flow opposite to the normal direction. In this case, it is the reverse flow of blood.

Causes of congenital tricuspid regurgitation

The most common reasons for this congenital pathology serve:

• underdevelopment of valve leaflets;
• abnormal development (number) of valve leaflets;
• connective tissue dysplasia;
• Ehlers-Danlos syndrome;
• Marfan syndrome;
• Ebstein's anomaly.

Tricuspid regurgitation in the fetus is very rare in isolation; it is usually combined with other heart defects. This valve insufficiency may be part of the mitral-aortic-tricuspid defect.

Causes of acquired tricuspid regurgitation

Acquired tricuspid valve regurgitation is much more common than congenital regurgitation. It can be primary and secondary. The primary causes of this pathology include rheumatism, drug addiction, and carcinoid syndrome.

1. Rheumatism- This is the most common cause of this pathology. In 20% of cases, it is the recurrent one that leads to deformation (thickening and shortening) of the valve leaflets, and the tendon threads also change in the same way. Very often this pathology is accompanied by stenosis of the right atrioventricular orifice. This combination is called combined tricuspid defect.
2. Papillary muscle rupture may also lead to tricuspid regurgitation. Such ruptures occur during myocardial infarction or may have a traumatic origin.
3. Carcinoid syndrome can also lead to this pathology. It occurs in certain types of oncology, for example, cancer small intestine, ovaries or lungs.
4. Taking hard drugs very often leads to infective endocarditis, and this, in turn, can cause tricuspid regurgitation.

The most common causes of secondary tricuspid insufficiency are the following diseases:

• dilation of the annulus fibrosus, which occurs with dilated cardiomyopathy;
• high degree of pulmonary hypertension;
• weakness of the right ventricular myocardium, which occurs in the so-called cor pulmonale;
• chronic heart failure;
• myocarditis;
• myocardial dystrophy.

Symptoms in children

Congenital tricuspid regurgitation in infants in 25% of cases manifests itself as atrial fibrillation, later severe

In older children, even with minimal exertion, shortness of breath appears and palpitations. The child may complain of heart pain. Dyspeptic disorders (nausea, vomiting, flatulence) and pain or a feeling of heaviness in the right hypochondrium may be observed. If stagnation occurs in the systemic circulation, peripheral edema, ascites, hydrothorax or hepatomegaly appear. All these are very serious conditions.

Symptoms of the disease in adults

If this pathology is acquired in more than late age, then on initial stage a person may not even be aware of it. Minor tricuspid regurgitation is manifested only in some patients by pulsation of the jugular veins. The patient does not note any other symptoms. Grade 1 tricuspid valve regurgitation may not manifest itself in any way. Usually this pathology is discovered completely by accident during the next medical examination. The patient undergoes echocardiography, which reveals grade 1 tricuspid regurgitation. He will find out what it is only after examination. Such patients are usually registered with a cardiologist and monitored.

With more severe valve insufficiency, significant swelling of the jugular veins is observed. In this case, if you place your palm on the right side, you can feel it shaking. In severe cases, this pathology leads to right ventricular dysfunction, atrial fibrillation, or can provoke heart failure.

Diagnostics

The diagnosis of “grade 1 tricuspid regurgitation” or some other can be made only after a thorough examination of the patient. To do this, you must go through the following procedures:

• physical examination method, i.e. listening to heart sounds and murmurs with a stethoscope;
• EchoCG (echocardiography) is an ultrasound of the heart that reveals the functional and morphological state of the heart muscle and valves;
• ECG, in which you can see signs of an enlarged right atrium and ventricle of the heart;
• chest x-ray - with this study enlarged sizes of the right ventricle are also detected, signs of pulmonary hypertension and deformation of the mitral and aortic valves can be seen;
• produce biochemical research blood;
• general blood analysis;
• Cardiac catheterization - this newest invasive procedure is used both for the diagnosis of cardiac pathologies and for treatment.

Classification

We found that tricuspid valve regurgitation can be congenital or acquired, primary (organic) or secondary (functional) by etiology. Organic failure is expressed by deformation of the valve apparatus: thickening and wrinkling of the valve leaflets or their calcification. Functional failure occurs when valve dysfunction is caused by other diseases and is manifested by rupture of the papillary muscles or chordae tendineae, as well as disruption of the annulus fibrosus.

Degrees of the disease

There are 4 degrees of this disease, which are characterized by the length of the return flow of blood into the cavity of the right atrium.

Tricuspid regurgitation 1st degree - what is it? In this case, the backflow of blood is insignificant and barely detectable. In this case, the patient does not complain about anything. Clinical picture absent.

With a diagnosis of “tricuspid regurgitation of the 2nd degree,” the reverse flow of blood is carried out within 2 cm of the valve walls. The clinical picture at this stage of the disease is almost absent; pulsation of the jugular veins may be weakly expressed.

Grade 3 tricuspid valve regurgitation is defined by backflow of blood more than 2 cm from the tricuspid valve. Patients, in addition to pulsation of the neck veins, may feel palpitations, weakness and fatigue, even with little physical exertion, slight shortness of breath may occur.

Stage 4 disease is characterized by a pronounced backflow of blood over a long distance from the valve into the cavity of the right atrium. At severe course the patient may experience symptoms of severe heart failure and pulmonary hypertension (pulmonary and tricuspid regurgitation). In this case, the symptoms listed above are joined by others. Namely: swelling of the lower extremities, a feeling of pulsation on the left in the sternum, which intensifies on inspiration, disturbance of heart sounds, cold extremities, enlarged liver, ascites (accumulation of fluid in the abdominal cavity), abdominal pain, and rheumatic nature This disease may cause aortic or mitral valve disease.

Treatment

Treatment methods depend on the degree of the disease, as well as whether it is accompanied by other heart defects and pathologies or not. When diagnosed with grade 1 tricuspid valve regurgitation, no treatment is usually required. Doctors consider this condition as a variant of the norm. If grade 1 tricuspid regurgitation is caused by some disease, for example, lung disease, rheumatism, or the provoking disease should be treated. If you get rid of the underlying disease, the further deformation tricuspid valve. So, grade 1 tricuspid regurgitation - what it is and how to treat it is now clear. Let's consider the next stage of this disease.

Grade 2 tricuspid valve regurgitation often does not require treatment either. If this pathology is associated with other heart defects or diseases, for example, heart failure, then treatment is necessary conservative methods. To do this, diuretics are used to reduce swelling and drugs that relax the smooth muscles of the walls of blood vessels (vasodilators). Tricuspid regurgitation of the 2nd degree does not require any other measures.

Treatment of grades 3 and 4 is also aimed at eliminating the disease that caused the regurgitation. If it does not bring results, surgical intervention is indicated. In this case, plastic surgery of the valve leaflets, their annuloplasty (suturing an elastic or rigid ring, or suturing the valve ring by suturing) or prosthetics are provided.

Mitral regurgitation

In case of incompetence, when its valves do not close tightly enough, a reverse flow of blood occurs from the left ventricle into the cavity of the left atrium during systole. This condition is called mitral regurgitation or mitral valve prolapse. This pathology, like tricuspid regurgitation, can be either congenital or acquired. The causes and diagnosis of mitral and tricuspid regurgitation are also similar. There are only 4 degrees that determine the severity of the disease, they depend on the amount of reverse blood flow:

• 1st degree - mitral regurgitation is insignificant;
• 2nd degree - mitral regurgitation is moderate;
• 3rd degree - mitral regurgitation is significantly expressed;
• 4th degree - mitral regurgitation is severe, often complicated.

Minor mitral, tricuspid regurgitation of the 1st degree, which does not cause objective complaints in the patient, does not require any treatment. Therapeutic treatment is carried out for complicated course of the disease, for example, cardiac arrhythmias or pulmonary hypertension. Surgery indicated for severe or severe mitral insufficiency, in these cases, plastic surgery or valve replacement is performed.

Combination of mitral and tricuspid insufficiency

Often, mitral and tricuspid regurgitation are diagnosed simultaneously in one patient. After a detailed examination and receipt of test results, the cardiologist will decide on the treatment tactics for such a patient. If valve insufficiency is mild, no treatment may be needed, but you will need to be periodically observed by a cardiologist and undergo the necessary examinations.

If the cause of valve insufficiency is established, then therapeutic treatment aimed at eliminating the provoking disease. In the absence of positive dynamics, surgical treatment of regurgitation is indicated. This usually happens when the disease is severe and severe.

Patients who have undergone surgical treatment of valve insufficiency are usually prescribed indirect anticoagulants.

Forecast

Secondary regurgitation is considered the most unfavorable prognostically. The death of patients in this case usually occurs from myocardial infarction, increasing heart failure, pneumonia or pulmonary embolism.

According to statistics, after surgical treatment of heart valve insufficiency, the survival rate of patients up to 5 years or more is 65% after prosthetics and 70% after annuloplasty.

The prognosis is favorable with a diagnosis of grade 1 tricuspid regurgitation. Patients usually find out what it is only during preventive examinations. With minor heart valve insufficiency there is no direct threat to life.

Conclusion

Prevention of mitral and tricuspid insufficiency involves preventing diseases that provoke valve failure. Namely, the treatment of rheumatism and other diseases that cause damage to the heart valves.