Tricuspid Regurgitation

Features:

Signs

• pan-systolic murmur - a holosystolic murmur that increases with inspiration (Carvallo's sign)
• prominent/giant V waves in JVP
• pulsatile hepatomegaly
• left parasternal heave

associated with right-sided heart enlargement, which can displace the apical impulse.

Right bundle branch block and left axis deviation on ECG also support right heart disease.

Causes

• right ventricular infarction
• pulmonary hypertension e.g. COPD
• rheumatic heart disease
• infective endocarditis (especially intravenous drug users)
• Ebstein's anomaly
• carcinoid syndrome

Tricuspid Stenosis