cardiovascular disorders
Tricuspid Stenosis
Diagnosis of Tricuspid Stenosis
Echocardiography Diagnosis of tricuspid stenosis is suspected based on history and physical examination and confirmed by Doppler Echocardiography showing a pressure gradient across the tricuspid valve. Two-dimensional echocardiography shows thickened leaflets with reduced movement and right atrial (RA) enlargement. Severe tricuspid stenosisis characterized by Mean forward gradient across the valve > 5 mm Hg Electrocardiography may show RA enlargement out of proportion to RV hypertrophy and tall, peaked P waves in inferior leads and V1. Chest x-ray may show a dilated superior vena cava and RA enlargement, indicated by an enlarged right heart border. Laboratory Tests of the Liver and Gallbladder are elevated because of passive hepatic congestion. Cardiac Catheterization is rarely indicated for evaluation of tricuspid stenosis. When catheterization is indicated (eg, to evaluate coronary anatomy), findings include elevated RA pressure with a slow fall in early diastole and a diastolic pressure gradient across the tricuspid valve. 