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, and therefore, no specific interventions are needed for valve issues based on these results. The mitral valve has a normal structure with a peak velocity of 1.2 m/s, no stenosis, and only trivial regurgitation, as well as a mitral valve area of 3.6 cm² and a mean gradient of 2 mmHg, which are within normal limits 1. The tricuspid valve similarly shows normal structure with no stenosis and only trivial regurgitation, which is frequently detected by echocardiography in normal subjects 1. Some key points to consider include:

• The mitral valve area is within normal limits, although slightly below the normal range of 4-6 cm²
• The mean gradient is normal, at 2 mmHg, which is below the threshold of 5 mmHg
• The tricuspid regurgitation is trivial, which is a common finding in normal subjects 1
• The inferior vena cava (IVC) caliber is 1.3 cm, which is normal, suggesting normal right atrial pressure estimated at 3 mmHg
• The tricuspid regurgitation velocity is 1.2 m/s, indicating normal right ventricular systolic pressure These findings collectively indicate healthy valve function without any significant valvular heart disease, and normal cardiac follow-up is appropriate.

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.