cardiovascular disorders
Tricuspid Stenosis
Key Points
Tricuspid stenosis is almost always due to rheumatic fever; tricuspid regurgitation and mitral stenosis are often also present. Heart sounds include a soft opening snap and a mid-diastolic rumble with presystolic accentuation; the murmur becomes louder and longer with maneuvers that increase venous return (eg, exercise, inspiration, leg-raising) and softer and shorter with maneuvers that decrease venous return (standing, Valsalva maneuver). Treatment includes diuretics andaldosteroneantagonists; surgical repair or replacement is rarely needed. 