From the Guidelines
The radial sign that occurs with tricuspid regurgitation is characterized by abnormal systolic c and v waves in the jugular venous pulse. This finding is supported by the 2006 ACC/AHA guidelines for the management of patients with valvular heart disease 1. The presence of a prominent v wave in the jugular venous pulse is a key clinical feature of tricuspid regurgitation, as it indicates the backward flow of blood through the incompetent tricuspid valve during ventricular systole. Some key points to consider when examining for this sign include:
- Positioning the patient at a 45-degree angle to optimize visualization of the neck veins
- Observing the neck veins with proper lighting to accurately assess the height of the jugular venous pulse and the prominence of the v wave
- Correlating the severity of tricuspid regurgitation with the height of the jugular venous pulse and the prominence of the v wave, as supported by the guidelines 1
- Considering other associated findings, such as hepatomegaly, peripheral edema, and right-sided heart failure symptoms, which may also be present in patients with significant tricuspid regurgitation.
From the Research
Radial Sign in Tricuspid Regurgitation
- The radial sign associated with tricuspid regurgitation is not explicitly mentioned in the provided studies 2, 3, 4, 5.
- However, the studies discuss the prognostic significance of tricuspid regurgitation in various conditions, including pulmonary arterial hypertension 3, 5 and acute heart failure 4.
- Tricuspid regurgitation is associated with negative prognosis, including increased mortality risk and poorer outcomes 3, 4, 5.
- The severity of tricuspid regurgitation is correlated with the severity of pulmonary arterial hypertension and right ventricular dysfunction 3, 5.
- Tricuspid valve repair may have detrimental consequences in patients with low right ventricular contractility 5.