tricuspid regurgitation

Think of a leaky valve on the low-pressure side of a plumbing system: when the pump pushes, a little water seeps backward toward where it came from. In tricuspid regurgitation the tricuspid valve, between the right atrium and right ventricle, fails to seal during systole, so blood leaks back into the right atrium and the veins draining into it.

Mild tricuspid leakage is extremely common and usually harmless. When it becomes significant, the backward pressure shows up in the body's veins: a raised jugular venous pulse in the neck, congestion of the liver, and swelling of the legs and abdomen. Because the right side of the heart handles low pressures, the picture is dominated by venous congestion rather than breathlessness.

Most often the valve itself is normal and the leak is secondary — the right ventricle and valve ring have dilated, usually because of long-standing left-sided heart disease or pulmonary hypertension that strains the right heart. Less commonly the valve is directly damaged by infection (notably in injection drug use), rheumatic disease, or a pacemaker lead. Management targets the underlying cause, and selected severe cases may benefit from valve repair.

Because secondary tricuspid regurgitation reflects problems elsewhere in the heart, its assessment is part of a broader evaluation rather than a standalone diagnosis.