What is the diagnosis for a patient with a tricuspid valve (TV) showing trivial regurgitation, normal structure, and a tricuspid regurgitation (TR) velocity of 1.2 meters per second (m/s)?

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From the Guidelines

The tricuspid valve is normal with trivial regurgitation, and no intervention is required as all parameters are within normal limits. The inferior vena cava (IVC) caliber is 1.3 cm, which is within normal limits, suggesting normal right atrial pressure, as supported by the European Society of Cardiology guidelines on valvular heart disease 1. This is confirmed by the measured right atrial pressure of 3 mmHg, which is also within normal range. The tricuspid regurgitation velocity is 1.2 m/s, indicating a low pressure gradient across the valve. Based on these findings, the right ventricular systolic pressure (RVSP) is likely normal, as the TR velocity is low.

Key Findings:

  • Normal tricuspid valve structure
  • Trivial regurgitation, which is a common finding even in healthy individuals, as noted in the 2014 AHA/ACC guideline for the management of patients with valvular heart disease 1
  • No stenosis
  • Normal IVC caliber (1.3 cm)
  • Normal right atrial pressure (3 mmHg)
  • Low tricuspid regurgitation velocity (1.2 m/s)

Clinical Implications:

  • No evidence of pulmonary hypertension or right-sided heart failure
  • Normal right heart function
  • Regular cardiac follow-up as per standard guidelines is appropriate, but no specific treatment is needed for the tricuspid valve based on these echocardiographic findings, in line with the guidelines provided by the American College of Cardiology/American Heart Association task force on practice guidelines 1.

From the Research

Tricuspid Valve Structure and Function

  • The tricuspid valve is a complex structure that plays a crucial role in maintaining cardiac function 2.
  • Tricuspid regurgitation is a common condition that affects approximately 1.6 million people in the United States, with many cases going untreated due to high surgical risk 2.
  • Echocardiography is a useful tool for assessing tricuspid valve function, particularly in the context of percutaneous repair and prosthetic valve implantation procedures 2, 3.

Tricuspid Regurgitation and Stenosis

  • Tricuspid regurgitation can be classified as trivial, mild, moderate, or severe, with moderate-to-severe regurgitation affecting a significant number of patients 2.
  • Tricuspid stenosis is a less common condition, but can still have significant clinical implications 3.
  • The assessment of tricuspid valve function using echocardiography can provide valuable information on valve gradients, pressure halftime, and Doppler velocity index 3.

Echocardiographic Evaluation

  • Echocardiography is a non-invasive tool that can provide quantitative data on tricuspid valve function, including valve gradients and regurgitation severity 3.
  • The use of two- and three-dimensional echocardiography can provide more accurate assessments of tricuspid valve function, particularly in the context of percutaneous repair and prosthetic valve implantation procedures 2, 3.
  • The correlation between invasive and non-invasive measurements of tricuspid valve gradients has been shown to be reasonable, although discrepancies can occur 3.

Clinical Implications

  • The assessment of tricuspid valve function has significant clinical implications, particularly in the context of percutaneous repair and prosthetic valve implantation procedures 2, 3.
  • The use of echocardiography can provide valuable information on valve function and guide clinical decision-making 2, 3.
  • Further research is needed to fully understand the clinical implications of tricuspid valve dysfunction and the role of echocardiography in its assessment 2, 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Echocardiographic Evaluation of Patients Undergoing Transcatheter Tricuspid Valve-In-Valve Replacement.

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2019

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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