From the Guidelines
The wrist sign that occurs with tricuspid regurgitation is not directly mentioned, however, a related sign is the pulsatile varicose veins, but more commonly associated is the systolic hepatic pulsation and a venous systolic thrill and murmur in the neck, no specific wrist sign is described in the context of tricuspid regurgitation. When considering tricuspid regurgitation, it's essential to look at the clinical features, which include abnormal systolic c and v waves in the jugular venous pulse, a lower left parasternal systolic murmur that may increase on inspiration, and systolic hepatic pulsation 1. Some key points to consider in the diagnosis of tricuspid regurgitation include:
- Abnormal systolic c and v waves in the jugular venous pulse
- A lower left parasternal systolic murmur that may increase on inspiration (Carvallo’s sign)
- Systolic hepatic pulsation
- In rare instances, severe TR may produce systolic propulsion of the eyeballs, pulsatile varicose veins, or a venous systolic thrill and murmur in the neck 1. Echocardiography is valuable in assessing tricuspid valve structure and motion, measuring annular size, and identifying other cardiac abnormalities that might influence tricuspid valve function, and Doppler echocardiography permits estimation of the severity of TR, RV systolic pressure, and the tricuspid valve diastolic gradient 1.
From the Research
Wrist Sign Associated with Tricuspid Regurgitation
There is no direct evidence in the provided studies to suggest a specific wrist sign that occurs with tricuspid regurgitation.
Available Information on Tricuspid Regurgitation
- Tricuspid regurgitation (TR) is a common finding, affecting about one in twenty-five subjects among the elderly, and presents more frequently in women than in men 2.
- TR can be distinguished as primary and secondary or functional TR (FTR), with the latter being the most prevalent 2.
- Significant TR leads to worsening prognosis regardless of the underlying etiology and should be addressed as a separate therapeutic target 2.
- TR in patients with heart failure with preserved ejection fraction (HFpEF) is related to right atrial (RA) remodeling, and the presence of atrial functional TR (AFTR) was associated with poor clinical outcomes 3.
- Increasing TR severity is associated with higher risk patients and increased mortality and readmission, particularly for patients with severe TR and left ventricular ejection fraction greater than 30% 4.
Limitations
There are no research papers among the provided evidence to directly assist in answering the question about the wrist sign that occurs with tricuspid regurgitation.