What is the diagnosis for a patient with a normal mitral valve structure, trivial mitral regurgitation, and trivial tricuspid regurgitation, with no stenosis in either valve?

From the Guidelines

The patient's echocardiographic findings indicate normal mitral and tricuspid valve function with trivial regurgitation, which is a common and clinically insignificant finding in healthy individuals. The mitral valve structure is normal with a peak velocity of 1.2 m/s, peak gradient of 6 mmHg, and a calculated valve area of 3.6 cm², which is within normal limits 1. There is no evidence of mitral stenosis, and the tricuspid valve also appears structurally normal with trivial regurgitation. The inferior vena cava (IVC) caliber is 1.3 cm, suggesting normal right atrial pressure, which is estimated at 3 mmHg. The tricuspid regurgitation velocity is 1.2 m/s, indicating normal right ventricular systolic pressure.

According to the guidelines on the management of valvular heart disease 1, trivial tricuspid regurgitation is frequently detected by echocardiography in normal subjects and is not a cause for concern. Pathological tricuspid regurgitation is more often functional rather than due to a primary valve lesion, but in this case, there is no indication of significant tricuspid regurgitation or any other valvular disease.

Key points to note from the echocardiographic findings include:

• Normal mitral valve structure and function
• Normal tricuspid valve structure and function
• Trivial regurgitation in both valves, which is clinically insignificant
• Normal right atrial pressure and right ventricular systolic pressure
• No evidence of mitral stenosis or significant tricuspid regurgitation.

Given these findings, no specific treatment or follow-up is needed based on these valve findings alone, though regular cardiac check-ups according to age and risk factors would be appropriate for general cardiovascular health maintenance 1.

From the Research

Mitral Valve Analysis

• The mitral valve structure is normal with a peak velocity of 1.2 m/s, indicating no stenosis 2.
• The mean gradient is 6 mmHg, and the pressure half-time is 2 mmHg, which are within normal limits.
• The mitral valve area is 3.6 cm², calculated using the pressure half-time method.
• Trivial regurgitation is present, but it is not significant.

Tricuspid Valve Analysis

• The tricuspid valve structure is normal, with no stenosis or significant regurgitation.
• The peak velocity is 1.2 m/s, which is within normal limits.
• There is a trivial amount of regurgitation, but it is not significant.
• The right ventricular systolic pressure (RVSP) and right atrial pressure (RA) are not significantly elevated.

Relationship between Mitral and Tricuspid Valve Disease

• Functional tricuspid regurgitation is a common finding in patients with left-sided heart disease, including mitral valve disease 3, 4.
• The presence of tricuspid regurgitation in patients with mitral valve disease is associated with poor outcomes, including reduced survival and functional capacity 4, 5.
• The mechanism of functional tricuspid regurgitation involves annulus dilation and leaflet tethering due to right ventricle remodeling 3.
• Surgical treatment of tricuspid regurgitation, including tricuspid annuloplasty, may be necessary in some cases, especially if the tricuspid annulus diameter is greater than 3.5 cm 4.