cardiovascular disorders
Tricuspid Stenosis
Introduction
Tricuspid stenosis (TS) is narrowing of the tricuspid orifice that obstructs blood flow from the right atrium to the right ventricle. Almost all cases result from rheumatic fever. Symptoms include a fluttering discomfort in the neck, fatigue, cold skin, and right upper quadrant abdominal discomfort. Jugular pulsations are prominent, and a presystolic murmur is often heard at the left sternal edge in the fourth intercostal space and is increased during inspiration. Diagnosis is by echocardiography. TS is usually benign, requiring no specific treatment, but symptomatic patients may benefit from surgery. (See also Overview of Cardiac Valvular Disorders .) Tricuspid stenosis is almost always due to Rheumatic Fever ; Rare causes of tricuspid stenosis include Systemic Lupus Erythematosus (SLE) , right atrial myxoma, congenital malformations, and metastatic tumors. The right atrium becomes hypertrophied and distended, and sequelae of right heart disease–induced Heart Failure (HF) develop but without right ventricular (RV) dysfunction; the RV remains underfilled and small. Uncommonly, atrial fibrillation occurs. 