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What Happens in Tricuspid Valve Regurgitation?

Medically reviewed by Mike Kenneth Go Doratan, MD · General Surgery · The Medical City Ortigas

Written by Desiree Gabasa · Updated Oct 28, 2020

What Happens in Tricuspid Valve Regurgitation?

Also referred to as tricuspid valve insufficiency, tricuspid regurgitation is a condition in which one of the valves of the heart, called the tricuspid valve, leaks. It is revealed by a distinct tricuspid regurgitation murmur on physical examination when your doctor hears your heart sounds.

The murmur is usually high-pitched, but oftentimes, not easily heard. This is because the sound is best perceived at the left lower chest, when the patient is either standing or sitting upright.

To better understand this, we must take a closer look at how the heart works.

How does the heart work?

The heart is the center of the circulatory system. It is made up of four chambers. These chambers are connected. Two upper chambers called atria receive blood, while two lower chambers called ventricles, which pump blood.

Four valves open and close to regulate blood flow between the chambers and in and out of the heart. Think of it as a faucet that either opens up to let blood flow spontaneously or closes up to entirely stop the flow. 

Tricuspid Valve vs Mitral Valve

For the most part, people have given more consideration to the mitral valve. This is the valve located at the left side of the heart, between the upper and lower left chambers. This primarily because most rheumatic heart diseases are related to abnormalities in the mitral valve. 

On the other hand, the tricuspid valve is located between the right atrium and right ventricle. It separates the two right chambers, flapping open to let the blood flow, and immediately closing to prevent blood from flowing backwards. 

Tricuspid valve regurgitation basically means that the valve did not close as tightly as it should. This causes blood to flow back into the right atrium when the heart beats. 

If a tricuspid regurgitation murmur is not detected immediately, it could lead to a weakened heart.

Heart Valve Disease: All You Need to Know

What are the symptoms of tricuspid valve regurgitation?

Tricuspid valve regurgitation is the most common type of tricuspid valve disease.

The most noticeable signs may include:

  • Swelling of the belly, legs or ankles
  • Fatigue and inability to tolerate exercise
  • Shortness of breath that may continue to worsen
  • Abnormal rhythms of the heart
  • pulsating feeling in the blood vessels in the neck

What causes tricuspid valve regurgitation?

Generally, tricuspid valve regurgitation can be either primary or secondary.

Primary regurgitation occurs when the leaflets or the chords that attach the tricuspid valve to the heart are affected.

Secondary regurgitation happens when there is annular dilation.

The annulus is the ring-like structure located between the lower and upper chambers and lodges the valve.

An enlarged annulus means that the valve leaflets are too stretched out causing the blood to leak backward. 

  • Birth defect or congenital heart disease
  • Tricuspid valve infection
  • Trauma on the chest

Causes of Secondary Regurgitation

  • Right ventricular enlargement
  • Pulmonary hypertension caused by extremely high pressure on the right side of the heart

Other causes of tricuspid valve regurgitation include:

  • Ebstein’s anomaly – a malformation in the tricuspid valve’s leaflets
  • Infective Endocarditis – an infection in the lining of the heart
  • Chest Irradiation
  • Rheumatic Fever
  • Valve damage during procedures like endomyocardial biopsy
  • Carcinoid syndrome – wherein tumors that develop in the digestive system produce a substance that may damage the heart’s valves

What are the risk factors of tricuspid valve regurgitation?

If you have the following conditions, you could be at high risk of developing tricuspid valve regurgitation:

  • Infections on the tricuspid valve or rheumatic fever
  • Rheumatoid arthritis or Marfan syndrome
  • Exposure to chest radiation that could damage the valves
  • Heart diseases, like heart attack or heart failure
  • Atrial Fibrillation, which is a common heart rhythm disorder
  • Congenital heart defects
  • Pulmonary hypertension
  • Use of selective medications like stimulants and other slimming drugs

Types of Heart Valve Disease

How is tricuspid valve regurgitation diagnosed?

It’s not easy to detect a tricuspid valve regurgitation murmur just by physical examination.

Unless it is prominently heard, you can only be diagnosed for this condition during its severe stage. 

  • During examination, provide information on previous illnesses or conditions, especially when it involves the heart and lungs. If you’ve been taking certain medications, make sure to inform the doctor as well.
  • The entire diagnostic process may also include an electrocardiogram (ECG) or chest X-ray.
  • You may also need to undergo a stress test to assess how your heart works under pressure.
  • Cardiac catheterization can also help measure the heart’s pressure.
  • An echocardiogram is the best way to spot a valve regurgitation. It is a type of ultrasound that shows how the heart is pumping and regulating blood.

How do you treat a tricuspid valve regurgitation?

Without any symptoms, there may be no need for a treatment just yet. Otherwise, medicines will be provided to treat any heart infection. You may also be given medicines (diuretics) to remove excess fluids by urinating a lot. This helps relieve pressure on the lungs.

For severe symptoms, there may be a need for surgery. This is usually done to repair or replace the tricuspid valve. 

It is also very important to treat other underlying conditions that could worsen your heart condition. These conditions include obesity and high blood pressure. 

What do you need to do to manage the symptoms?

Aside from medication and possible operation, you may need to introduce quite a lot of changes in your lifestyle from now on. 

Regulate your food intake 

Eat healthy food that includes fruits and vegetables. Steer clear of salty and processed provisions as these could cause fluid buildup. Instead of butter, go for olive oil.

Binge on heart-healthy foods like beans, lean meat, tuna and walnuts, to name a few. 

Stay fit

If you are overweight, you can actually increase your chances of developing a heart disease.

Keep your heart healthy and maintain a healthy weight through regular exercise. Ask your doctor what types of exercises are safe and beneficial to your condition.

Lifestyle Changes to Improve Your Heart Health

Stay away from alcohol and smoking

Constant alcohol and smoking can cause heart, liver and lung problems. It may be pretty difficult to quit, but it’s something that you should seriously look into immediately. 

Any health condition that involves the heart can be very quite worrying.  The key here is early detection and treatment. If you suspect a tricuspid valve regurgitation, make sure that you pay your doctor a visit immediately for prompt recognition of a tricuspid regurgitation murmur and other possible underlying heart conditions to ensure your overall health. 

Learn more about heart valve disease, here.


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

Mike Kenneth Go Doratan, MD

General Surgery · The Medical City Ortigas

Written by Desiree Gabasa · Updated Oct 28, 2020

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