Tricuspid Insufficiency Definition, Reason, Symptoms, Treatment & Prevention
Understanding
The condition of tricuspid insufficiency is a disorder of the tricuspid valve which is characterized by a valve that is loose and cannot close tightly. There are four valves in the heart, namely the mitral, tricuspid, aortic and pulmonary valves. The tricuspid valve is the valve that separates the right atrium and right ventricle of the heart.
Tricuspid insufficiency is also known as tricuspid regurgitation. This condition is relatively rare. It is estimated that only one percent of the world’s population experience it.
Symptom
Patients with tricuspid insufficiency generally experience symptoms that are the result of right heart failure. Symptoms usually appear in the form of an enlarged abdomen due to accumulation of fluid in the abdominal cavity, enlarged liver and spleen, and swelling of both lower limbs.
If not handled properly, symptoms of left heart failure can also occur. Symptoms include shortness of breath that gets worse when walking long distances or doing strenuous activities, shortness of breath that occurs suddenly when the sufferer is sleeping, or shortness of breath when lying flat on the bed. In some cases, complaints of chest pain can occur during activities.
Usually, people with tricuspid insufficiency also look thin, and the skin can appear yellow due to disorders in the liver.
Reason
Tricuspid insufficiency can be caused by several underlying diseases. The most common diseases are:
- Rheumatic heart disease
- Infective endocarditis (heart infection due to bacteria or fungi)
- Ebstein anomaly (congenital heart valve disorder)
- Injury to the heart
- Side effects of drugs such as pergolide (a drug for Parkinson’s) and fenfluramine (a drug for obesity)
- Marfan syndrome (an inherited disorder that occurs in the connective tissue)
- Osteogenesis imperfecta (a type of disease that causes impaired bone formation)
Diagnosis
During the initial examination to determine the diagnosis of tricuspid insufficiency, the doctor will conduct a detailed medical interview regarding the complaints you are experiencing. The doctor will also do a complete physical examination, including checking heart sounds with a stethoscope. In tricuspid insufficiency, you will hear abnormal heart sounds in the form of murmurs in the systolic phase (when the heart pumps blood to the lungs and the rest of the body).
Furthermore, to confirm the presence of tricuspid insufficiency, it is necessary to perform an echocardiographic examination. Through this examination, all heart valves can be seen clearly. If valve abnormalities are found, the severity of the abnormalities experienced can also be assessed through echocardiography.
Another examination that may be needed is an X-ray. Based on this examination, an enlarged heart and dilated veins in the heart can be found.
Treatment
Treatment of tricuspid insufficiency depends on the cause of the insufficiency and the degree of severity. Therapy with drugs is needed to overcome the symptoms of heart failure that occur.
The drugs given are generally diuretic drugs. Diuretic drugs will encourage some of the blood to be excreted through the urine. The goal is to reduce the amount of blood volume so that it will reduce the workload of the heart.
Other drugs used are usually ACE inhibitors (angiotensin-converting enzyme inhibitors ) such as captopril and ramipril. This type of drug is generally used to treat hypertension. In cases of tricuspid insufficiency, this class of ACE inhibitor drugs is given to prevent the heart muscles from experiencing enlargement and impaired contractions, so that symptoms of heart failure do not occur.
Meanwhile, surgery is the main therapy for tricuspid insufficiency. The operation performed was to replace the tricuspid valve with an artificial valve. However, not all people with tricuspid insufficiency need surgery.
Surgery is especially necessary on:
- Severe tricuspid insufficiency
- The tricuspid valve is damaged by bacteria in infective endocarditis
- Complaints do not improve with medication
Patients with tricuspid insufficiency are strongly advised to undergo regular check-ups with a cardiologist to monitor and prevent symptoms of heart failure from occurring.
Prevention
Until now there is no action that can be done to prevent tricuspid insufficiency.