Tricuspid valve insufficiency

Tricuspid insufficiency of the 2nd degree is characterized by a violation of blood flow from the right ventricle to the right atrium, which occurs due to incomplete closure of the tricuspid valve leaflets.

Tricuspid insufficiency (TI) occurs as a result of dysfunction of the heart valve. In medicine, pathology is referred to as acquired heart defects. The essence of this deviation lies in the loose closure of the valves, which can be caused by various reasons: injuries, changes in shape or destruction of the valve. The result of these processes is the reverse ejection of blood from the ventricle to the atrium on the right side.

Causes of TN

Tricuspid valve insufficiency can be caused by many diseases or abnormalities, among which are:

1. Inflammatory process localized in the membrane of the heart. According to statistics, this disease is the most common cause of TN.
2. Infectious lesion of the endocardium.
3. Damage to the right ventricular myocardium, which arose as a result of manifestations of diseases such as inflammation of the heart muscle, death of heart tissue when blood flow stops, scarring on the valve.
4. Heart injury or valve leaflet rupture.
5. The presence of a chronic form of heart failure (HF) in a patient.
6. Pulmonary hypertension.
7. Various damage to the valvular apparatus caused by a change or break in the chords, as well as damage to the muscles that act as a continuation of the left ventricular myocardium.
8. Complications after operations aimed at eliminating mitral valve stenosis.

Second degree tricuspid insufficiency

The pathology of the tricuspid valve is due to the fact that there is an incomplete closure of its valves, as a result of which the blood at the time of contraction of the heart muscle is thrown in a certain amount from the ventricle into the right atrium. This leads to an increase in the volume of the organ and an increase in pressure in the atrium on the right. As a result of excessive load, the size of the heart chamber increases, which causes pain in the patient.

Since the atrium does not have the proper compensatory capabilities, a patient with TN may experience:

• a sharp increase in venous pressure;
• right ventricular failure;
• obstructed outflow of blood in the liver;
• decrease in blood circulation, which is associated with a small amount of ejected blood from the right ventricle.

Unlike grade 2, grade 1 TN occurs without any symptoms and does not affect the patient's well-being. At the same time, it can only be detected using Dopplerography, since it cannot be fixed on the ECG. This difference suggests that pathology of grade 2 and above may be accompanied by secondary changes and be severe.

With the development of the disease to the 2nd degree, the patient is observed:

• increased volume of back-moving blood;
• with an increase in the level of TN, characteristic symptoms appear;
• there is a physical malaise and a decline in the activity of the patient;
• right ventricular malaise leads to an increase in the body in volume, resulting in increased tricuspid insufficiency.

Symptoms of tricuspid insufficiency of the 2nd degree

Among the symptoms that causes tricuspid insufficiency, the most pronounced are:

• a decline in the patient's strength, as a result of which working capacity decreases, and the level of physical activity drops significantly;
• feeling of irregular work of the heart;
• frequent urination at night;
• in the evening, swelling of the legs below the knee increases;
• false feeling of freezing of the lower extremities;
• under the ribs on the right, heaviness is felt;
• a feeling of bloating;
• dyspnea;
• pulsation of the cervical vessels, as well as their noticeable swelling;
• during a one-time palpation of the right ventricular region and the liver, their pulse rhythm does not match;
• when listening to the heart, extraneous noises, atrial fibrillation appear;
• the face acquires a yellowish tint and swells;
• the liver increases in size;
• fluid begins to accumulate in the abdominal cavity;
• dyspepsia appears.

As the degree of TN increases, so does the number of symptoms. The first of these is usually weakness and fatigue, which is often ignored by patients. This leads to the fact that tricuspid valve insufficiency increases, when it is necessary to start its treatment immediately.

Tricuspid valve insufficiency in children

Newborns who have regurgitation with the manifestation of cardiac pathologies are prone to the rapid development of right ventricular failure, respiratory dysfunction, which often leads to death.

Most often, acquired TN in babies develops as a result of complications of other diseases. The most common case is streptococcal infection, which also leads to rheumatic lesions.

Also, the reasons for the development of TN in children can be:

• acute form of hypertension;
• cardiomyopathy;
• myocardial disease;
• trauma;
• malignant tumors.

TN of the first degree in newborns can be considered as a feature of the anatomical structure. At this stage, treatment is not prescribed, since with age the disease can go away by itself.

Diagnosis and study of TH

Due to the fact that the first stage of the disease is asymptomatic, most often it can be detected already when tricuspid insufficiency progresses to the second degree.

Accordingly, the diagnosis of the disease is also carried out at the second stage and includes such measures as:

• collection of information about the patient's well-being, his complaints and anamnesis analysis;
• examination of the physical manifestations of TN (the presence of swelling of the veins in the neck, pulsation, bloating, and others);
• listening to the heart rhythm to detect murmurs or arrhythmias;
• measurement of blood pressure;
• collection of primary blood and urine tests.

Research is carried out using:

• electrocardiogram, which shows an increase in the size of the heart, right ventricle and atrium;
• coronary cardiograms for blood circulation analysis;
• tomography for viewing the cardiac image in multidimensional form;
• catheterization, which allows you to measure the level of right ventricular pressure and atrial parameters;
• x-rays to determine the configuration, location and size of the heart;
• doppler echocardiography to detect reverse movement of blood and body fluids;
• echocardiography, which allows you to assess the degree of pathological changes in the tricuspid valve, defects and the condition of its valves;
• phonocardiograms to detect systolic murmur.

Treatment of tricuspid insufficiency

Treatment for deficiency depends on the symptoms and the severity of the disease.

In this case, therapy is prescribed individually for each patient, taking into account concomitant diseases.

Treatment methods can be both medical and surgical.

Medications are prescribed:

• for the treatment of diseases that provoked the occurrence of TN;
• as a therapy aimed at restoring circulatory functions;
• for the treatment and prevention of heart failure or arrhythmias.

With drug treatment, the patient is advised to limit the intake of salt and large amounts of liquid.

As surgical methods are used:

• tricuspid valve plasty;
• prosthetics using mechanical valves or bioprostheses.

Preventive measures

For prevention, doctors recommend activities that reduce the risk of developing inflammatory processes. Also, patients must adhere to all prescribed procedures and therapy to minimize complications.

Self-medication for tricuspid insufficiency is strictly prohibited, as well as changing the dosages of medications prescribed by a doctor or self-replacing drugs. To help the body, the patient must change his lifestyle, eliminate all bad habits.