Blood flows around your body in a one-way system and your body has developed a couple of strategies to ensure it stays that way, valves are one of those essential structures that are required to prevent any backflow of blood. Within your heart you have four valves performing this exact function, however, in some cases, there may be an issue with a valve that disturbs this system and an example of this is stenosis. Stenosis is where a valve is much narrower than it should be and this can put the heart under a lot of strain. In this article you will find out about stenosis of a particular valve called the tricuspid valve and how this can affect someone who has it.
Your heart is made up of four chambers. The role of the two atria at the top is to pump blood into the bottom chambers called ventricles whose role is to then pump blood out of the heart. The right atrium receives blood from the rest of your body after your body has used up all the oxygen the blood was carrying and pumps it into the right ventricle. The right ventricle then pumps blood to the lungs where the blood can then absorb oxygen for your body to use. The blood from your lungs then immediately returns to the heart but enters through the left atrium. This then pumps blood into the left ventricle which will then pump blood to the rest of your body and the cycle continues. The tricuspid valve is the valve that lies between your right atrium and your right ventricle but tricuspid stenosis is a relatively rare disorder accounting for only 2.4% of all tricuspid valve abnormalities.1, 2
However, like stenosis in any other valve in the heart, tricuspid stenosis increases resistance to blood flow. This means over time your right atrium has to work harder to pump blood through the valve and into the right ventricle. The muscle that makes up your right atrium will get thicker over time this will allow it to contract with much more force and create much more pressure to force blood into the right ventricle. But this will lead to the disruption of the pressure system within your heart and your lungs, which can lead to heart failure over time.
Causes of tricuspid stenosis
Tricuspid stenosis may be caused by
- Rheumatic Heart disease is the most common cause of tricuspid stenosis and is the result of a condition called rheumatic fever. Rheumatic fever develops as a result of an autoimmune response after having a strep throat infection and can lead to damage to the heart valves
- People are rarely born with tricuspid stenosis. It can occur during foetal development as congenital heart disease
- Metastasized tumours (cancer that has spread) can also cause tricuspid stenosis
Signs and symptoms of tricuspid stenosis
Tricuspid stenosis normally does not cause any symptoms however, symptoms that can occur are similar to those in heart failure and include:
- Breathlessness at rest, when asleep or when active
- Swelling in the legs
- Abdominal bloating
- When a doctor listens to the heart of someone with tricuspid stenosis they may hear a rumbling sound called a heart murmur
Diagnosis of tricuspid stenosis
Tricuspid stenosis is diagnosed using
- Echocardiogram: a type of imaging that allows the view of all the structures in the heart. This shows the diameter of the valve and any changes in the structure of the heart
- Cardiac catheterization/cardiac cath/angiogram
- Chest X-ray
- Electrocardiography (EKG)
- Blood tests
Management and treatment for tricuspid stenosis
Previously mentioned tricuspid stenosis often causes no symptoms so there may not be any treatment options available. However, you might be given diuretics to relieve the symptoms like breathlessness. In case someone has very severe tricuspid valve stenosis then a valve replacement surgery might be recommended. This is a surgery where the tricuspid valve is removed and replaced with a mechanical one.
How common is tricuspid stenosis?
Tricuspid stenosis is very rare making up only 2.4% of those with tricuspid valve abnormalities and affecting 3% of the population worldwide.1
How can I prevent tricuspid stenosis?
Preventing rheumatic heart disease with prompt antibiotic use and completing the course of antibiotics if you have strep throat is the most common way to develop tricuspid stenosis.3
Who is at risk of tricuspid stenosis?
Those who develop rheumatic fever as well as those who have congenital heart disease are at higher risk.
When should I see a doctor?
If you experience any of the previously mentioned symptoms, seek medical attention urgently. Though tricuspid stenosis in itself is quite rare and mostly asymptomatic, the development of symptoms implies very severe tricuspid stenosis and heart failure.
Tricuspid stenosis is a very rare valvular defect. It is marked by the narrowing of the tricuspid valve. People with rheumatic heart disease, congenital heart defect, tumour that has spread etc. are more likely to develop tricuspid stenosis. It generally does not cause symptoms however if you start noticing symptoms then it is a sign that there is a very severe narrowing of the tricuspid valve. Please visit your GP in case you experience any uneasiness.
- Kolte D, Kennedy KF, Passeri JJ, Inglessis I, Elmariah S. Temporal trends in prevalence of tricuspid valve disease in hospitalized patients in the united states. The American Journal of Cardiology [Internet]. 2020 Jun [cited 2023 Nov 13];125(12):1879–83. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0002914920302836
- Golamari R, Shams P, Bhattacharya PT. Tricuspid stenosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Nov 13]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK499990/
- Wyber R, Bowen AC, Ralph AP, Peiris D. Primary prevention of acute rheumatic fever. Aust J Gen Pract [Internet]. 2021 May 1 [cited 2023 Nov 13];50(5):265–9. Available from: https://www1.racgp.org.au/ajgp/2021/may/primary-prevention-of-acute-rheumatic-fever