Tricuspid Regurgitation

  • Tricuspid regurgitation is a fairly common lesion in the 21st century, likely due to the large number of patients who are surviving longer after bouts of endocarditis, pulmonary hypertension, severe left heart disease, etc.
  • The murmur is usually soft, heard along the lower left sternal border, and gets louder with inspiration (Carvallo’s sign).
 

Patient 1:

This is a young woman with non-ischemic cardiomyopathy related to methamphetamine use, who was admitted to the hospital for decompensated heart failure. She was found to have functional tricuspid regurgitation. Notice the holosystolic murmur that increases in intensity with inspiration (Carvallo’s sign).

This patient also has a right-sided S3 gallop that was visualized via precordial movement.

Tricuspid Regurgitation

Annotated

Tricuspid Regurgitation

Annotated

Patient 2:

This is an older man with dilated cardiomyopathy complicated by severe tricuspid valve regurgitation. Notice that the murmur occurs late in systole and has a honk quality, suggestive of tricuspid valve prolapse.

This patient also has Lancisi’s sign. 

Tricuspid Regurgitation

Annotated

Patient 3:

This patient has tricuspid regurgitation. Notice the holosystolic murmur.

Tricuspid Regurgitation

Annotated

Patient 4:

This patient has tricuspid regurgitation. Notice the holosystolic murmur.

Tricuspid Regurgitation

Annotated

Patient 5:

This patient has tricuspid regurgitation. Notice the holosystolic murmur.

Tricuspid Regurgitation

Annotated

Patient 6:

This patient has tricuspid regurgitation murmur – Carvallo’s sign.

Tricuspid Regurgitation 

Annotated

Patient 7

This patient has Tricuspid Regurgitation from Infective Endocarditis with Carvallo.