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 only trivial regurgitation, requiring no specific intervention or follow-up. 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 the normal range 1. According to the guidelines on the management of valvular heart disease 1, trivial tricuspid regurgitation is frequently detected by echocardiography in normal subjects, and in this case, both valves show only trivial regurgitation.

The tricuspid valve appears structurally normal with trivial regurgitation, an inferior vena cava (IVC) caliber of 1.3 cm, suggesting normal right atrial pressure, estimated at 3 mmHg 1. The tricuspid regurgitation velocity is 1.2 m/s, indicating normal right ventricular systolic pressure. Key points from the echocardiographic findings include:

• Normal mitral valve structure and function
• Normal tricuspid valve structure and function
• Trivial regurgitation in both valves, which is a common finding even in healthy individuals 1
• No evidence of mitral stenosis or significant tricuspid regurgitation

Given these findings, no treatment or follow-up is required for the valve conditions, as they are within normal limits and do not indicate any significant pathology 1. The patient's valve function is consistent with normal cardiac valvular assessment, and the trivial regurgitation observed does not necessitate intervention 1.

From the Research

Mitral Valve

• The mitral valve structure is reported as normal with a peak velocity of 1.2 m/s and no stenosis 2, 3.
• The mean pressure gradient is 6 mmHg and the mitral valve area (MVA) is 3.6 cm², calculated using the pressure half-time method 3.
• Trivial regurgitation is present, which is consistent with findings in patients with normally functioning prosthetic valves 3.

Tricuspid Valve

• The tricuspid valve structure is reported as normal with no stenosis and trivial regurgitation 2, 4.
• The peak velocity is 1.2 m/s, which is within normal limits 3.
• There is a significant variation in the tricuspid valve gradient with respiration, and the inferior vena cava (IVC) calibre is 1.3 cm 4.
• The right atrial pressure is 3 mmHg, and the right ventricular systolic pressure (RVSP) is not specified 4.

Valve Regurgitation

• The presence of mitral regurgitation (MR) and tricuspid regurgitation (TR) can have significant implications for patient outcomes, particularly in those with severe aortic stenosis 2.
• Atrial fibrillation can lead to annular dilatation and valvular regurgitation, particularly in the tricuspid valve 5.
• The treatment of TR in patients undergoing left-sided cardiac surgery is well established, but isolated surgical repair of TR is rarely performed due to high perioperative mortality 4.