This entity presents as left ventricular overload in which there is a large stroke volume generated by left ventricular dilatation and left ventricular hypertrophy tends to normalize systolic stress. Unfortunately, dilatation is ordinarily accompanied by an elevation of the diastolic stress of the heart. But at that point may actually be late to repair. The most typical sense Tricuspid stenosis is dramatic when significant mitral valve disease or tricuspid stenosis is due to the carcinoid syndrome. These patients have a prominent A-wave and a slow Y descent and a murmur which varies with inspiration.
Echocardiogram is diagnostic.
Tricuspid regurgitation usually is functional as a consequence of pulmonary hypertension due to left sided heart disease. Either myocardial disease resulting in bi-sided heart failure, pulmonary hypertension, or mitral valve disease resulting in pulmonary hypertension and the tricuspid regurgitation secondarily. The other cause is infective endocarditis, particularly in patients who inject intravenous drugs. These patients have large V-waves with a rapid Y descent, distended neck veins, and they have a loud murmur which varies with inspiration. Ordinarily they have chronic atrial fibrillation.