Moderate grade 2 tricuspid regurgitation in newborns. What is tricuspid regurgitation: are people with pathology accepted into the army? Features of regurgitation in children

In a cardiologist's office, a patient may encounter terms whose meaning is unclear and therefore sound scary.

One such medical concept is regurgitation.

What do cardiologists call tricuspid regurgitation and grade 1 mitral regurgitation and how dangerous is this for health?

This is a phenomenon in which part of the blood returns to the cavity of the heart, from which the main blood flow comes.

This is not a disease, but it can diagnose a pathological condition of the cardiovascular system. Normally, the valve does not allow flow to return, since the valves close very tightly.

The term is applied to all heart valves and, depending on the reverse flow of blood, has several degrees of return blood flow, which are determined by an ultrasound specialist.

There is such a term as physiological regurgitation. It is characterized by minimal turbulence of blood at the valve, which does not harm the cardiovascular system.

The first degree is considered physiological, occurring in healthy people who are thin and tall. This blood flow feature does not cause clinical symptoms.

Main types of reverse blood flow

In total, there are three types of return blood flow: mitral, aortic, tricuspid.

Mitral valve prolapse causes mitral regurgitation.

A certain amount of blood is thrown into the left atrium through a loosely closed MV. In this case, part of the heart is stretched from the blood overflowing it from the pulmonary artery.

Overload of the atrium causes its thickening and expansion, the so-called dilatation.

For some time, the violation does not make itself felt, as compensation occurs due to the enlargement of the atrium cavities.

With mitral regurgitation of the first degree, a small reflux does not cause clinical changes in the functioning of the heart; health problems in patients arise in the second and third stages of prolapse - with an increase in the reverse flow of refluxed blood.

Causes causing prolapse:

Cardiologists diagnose grade 1 mitral regurgitation by a murmur recorded in the upper part of the heart or during an ultrasound examination; the patient himself does not complain.

The disorder does not require treatment, only observation by specialists.

Aortic regurgitation

Reverse reflux of blood through the aortic valve is caused by valve insufficiency, damage to the vessel, or an inflammatory process in it.

Causes of the problem:

What is characteristic of the aortic form? Overflow of the left ventricle as a result of backflow from the aorta.

Blood does not completely enter the systemic circulation, oxygen starvation occurs, compensation for the phenomenon occurs due to an increase in the total volume of the heart.

The violation has several degrees. The first does not affect health. A minor degree allows a person to lead a normal life for many years.

Hemodynamic impairment occurs gradually and is associated with an increase in the volume of the left ventricle, the needs of which for nutrients and oxygen are no longer provided by the coronary arteries. Phenomena such as ischemia and cardiosclerosis occur.

The progression of the problem is fraught with the following symptoms:

• weakness;
• pale skin;
• strong heartbeat;
• attacks of angina.

Tricuspid regurgitation

The disorder is caused by problems with the tricuspid valve and is associated with failure of the left side of the heart. Most often occurs in combination with other organ defects. The tricuspid form prevents normal filling of the pulmonary artery with blood, as a result of which the lungs suffer from oxygen starvation.

Minimal regurgitation does not cause clinical symptoms. Increasing the problem leads to the following picture:

Reverse reflux of blood through the valve in children

Blood flow problems in pediatric patients are associated with congenital heart abnormalities:

• septal defects;
• tetralogy of Fallot;
• underdevelopment of pulmonary artery valves.

Painful symptoms begin to appear immediately after the birth of the child. Babies have bluish skin, have trouble breathing, and have trouble latching on.

Newborns with such symptoms are examined by a cardiologist, they are sent for an ultrasound, and then the choice of method to eliminate the problem is determined - most often this is surgery.

Treatment methods

Treatment depends on the cause and severity of the problem. Its tactics are determined by the presence of concomitant diseases.

Minor backflow does not require medical or surgical treatment; patients undergo an ultrasound examination at a certain period.

In more complex cases, surgical intervention is necessary, this may be plastic surgery or prosthetics. The drug treatment carried out is aimed at restoring normal blood circulation, getting rid of arrhythmia and heart failure.

Patients are prescribed beta-blockers, diuretics, and antihypertensive drugs according to indications.

The prognosis of valve insufficiency depends on the degree of impairment, somatic diseases of internal organs and the age of the patients. Surgical correction allows patients to live a long, active life.

Proper nutrition for minor disorders

The diet of adults and children with mild heart failure includes plant foods, dairy and other animal proteins in the amount necessary for normal heart function. A diet for patients with cardiac problems is prescribed by a doctor.

If you are overweight, it is important to eat low-calorie foods that contain minimal cholesterol.

Animal fats in the diet are replaced by vegetable fats containing polyunsaturated acids. However, here you need to remember that cooking oils reduces their beneficial properties, so it is advisable to add them to salads.

Proteins necessary for life are contained in the following products:

• fish;
• lean meat;
• milk;
• cottage cheese;
• cheeses;
• mushrooms;
• legumes;

Carbohydrates are a source of energy. However, it is advisable for cardiac patients to consume foods containing these substances in a simple, easily digestible form: fructose, sucrose, galactose.

Complex carbohydrates contain starch and fiber (vegetables, fruits, grains, herbs).

Unlike the dietary table for other groups of patients, smoked foods, pickles and marinades are allowed, but in minimal portions.

Tricuspid valve regurgitation is a type of heart disease that is caused by the return flow of blood into the atrium from the right chamber ventricle in the systolic state. The main cause of the disease is valve insufficiency, i.e. The doors do not close completely.

ATTENTION!

The article will provide information about the degree of development of the disease, symptoms in children and adults, as well as therapeutic measures and prognosis.

As you read the review, the reader may have questions.

Consultations are conducted by qualified portal specialists free of charge 24 hours a day.

There are two types of valve regurgitation - congenital and acquired.

The causes of the congenital form are:

• fusion of valves;
• anomaly in the quantitative composition of valves;
• improper development of connective tissue;
• Ehlers-Danlos disease, Marfan disease and others.

The isolated degree of this disease develops extremely rarely. It often occurs along with other diseases. Dysfunction can occur with mutual defects in the mitral, tricuspid and aortic valves.

ATTENTION!

Many of our readers actively use a well-known method based on natural ingredients, discovered by Elena Malysheva, to treat HEART DISEASES. We recommend that you check it out.

Factors influencing the development of an acquired defect are the following:

• Primary degree: presence of rheumatism, drug use. At the same time, rheumatism is recognized as the main cause of the development of pathology. Approximately 25% of all cases are attributed to rheumatic endocarditis, as a result of which the valves and tendon threads are deformed.
• Secondary degree: stenosis of the opening between the ventricle and the atrium of the right chamber, rupture in the papillary muscles, carcinoid syndrome. The disease also develops against the background of cancer of the reproductive system and gastrointestinal tract. Often the use of hard drugs leads to the diagnosis of “Infective endocarditis”.

The next section will provide information on how the disease develops and what internal organs it can affect.

Classification of the disease

In medicine, there are four degrees of heart valve regurgitation:

• 1st degree. There is minimal return of blood flow. There are no symptoms or clinical signs, so the patient does not experience discomfort.
• 2nd degree. The return of blood occurs within a range of two centimeters from the walls. There are also no signs of the disease, but an increase in the pulse in the jugular veins can indicate the disease.
• 3rd degree. At this stage of the disease, blood flow exceeds the two-centimeter limits in the valve. A person feels a strong pulsation in the veins of the neck, a rapid pulse and a sense of heart rhythm, weakness in the body, decreased productivity and activity even with minor exertion. Shortness of breath is also present.
• 4th degree. Blood flow occurs in all valves and goes into the atrium of the right chamber. If health deteriorates, the patient observes such signs as heart failure, pulmonary hypertension, swelling of the legs, increased pulse in the sternum, numbness of the extremities. At the same time, the liver enlarges, ascites, pain in the stomach, and more appear.

Thus, we see that with grades 1 and 2, the patient may not notice the development of the disease, and the transition to the next stage disrupts the usual way of life. Therefore, cardiologists recommend that absolutely all people undergo an annual examination in order to prevent the disease and neutralize it in the first stages.

Clinic and symptoms of the disease

Stage 1 tricuspid regurgitation has clinical signs that are mild or absent altogether. These include:

• swelling;
• enlarged veins in the neck;
• dyspnea;
• high fatigue;
• feeling of heartbeat.

As for symptoms, in 20% of children during the infancy period the disease can manifest itself as gastric tachycardia.

This later develops into heart failure. At an older age, even with minor exertion, shortness of breath and rapid heartbeat appear.

The child often complains of pain in the sternum. Vomiting and nausea may occur systematically, as well as pain under the ribs on the right side. Severe conditions include swelling, accumulation of fluid in the pleural region, and enlarged liver.

Symptoms in adults are characterized depending on when the disease began. For example, if it began to develop in adulthood, then the disease can be found out during the autopsy, because nothing said about its presence.

Often, regurgitation, especially in the first degree, does not manifest itself in any way and is detected randomly during diagnosis if another disease is suspected. Therefore, if during the examination such a disease of the tricuspid valve is detected, the patient is registered and systematically observed.

Diagnostic methods

Valve pathology can be detected by echocardiography and electrocardiography. Additional methods include chest x-ray. But, despite the popularity of all these methods, ultrasound examination of the heart is considered the most informative. This is due to the ability to assess organ cavities and the condition of the tricuspid valve.

When performing an ECG, symptoms of the disease can be detected by an enlarged ventricle of the right chamber of the heart. The first stage of the disease can only be detected by chance. But development into the second degree already makes it possible to detect signs of regurgitation on an x-ray, namely how the atrium of the right chamber has enlarged.

In rare cases, a catheterization study is performed. This approach is necessary to analyze the functions of the valve and is most often carried out before surgery.

Of course, diagnostic methods include collecting patient complaints and listening to heart sounds and murmurs. During auscultation, the doctor can hear how the 1st and 2nd sounds of the organ change.

Therapeutic and preventive measures

First of all, treatment and prevention of tricuspid valve regurgitation consists of neutralizing the main ailment as a result of which the valve defect developed. For example, rheumatism, infective endocarditis, heart failure and others.

If the first degree does not affect hemodynamics, then treatment is usually not carried out. In other cases, drug therapy is required, which includes:

• elimination of the underlying disease;
• stabilization of blood supply;
• treatment of heart failure and arrhythmia.

Drug therapy includes taking diuretics, nitrates, glycosides, inhibitors, potassium-based drugs and others. All medications are prescribed by a doctor, and the dosage and course are prescribed after a full examination and based on the physiological characteristics of the body.

Treatment of severe stages of valve regurgitation is carried out in combination with conservative and radical measures. Traditional methods include taking glycosides and diuretics. The patient must drink a lot of water according to the regimen and avoid salt.

As for surgery in this matter, it is performed if valve insufficiency manifests itself in severe or moderate form. The indication for surgery is damage to the mitral valve due to pulmonary hypertension.

Methods of surgical intervention include plastic surgery and installation of a prosthesis.

Doctors often recommend anuloplasty, during which the fibrous ring of the valve is sewn to the prosthesis, or they use a technique to reduce its diameter.

The installation of a prosthesis is not always carried out, but only in cases where other surgical methods do not bring the expected result or due to contraindications to surgery. Porcine biomaterial is used as a material for the tricuspid valve prosthesis, because... it imitates the human one to a greater extent.

Forecasting

Regurgitation of the secondary form has a poor prognosis. Mortality occurs due to heart attack, progressive heart failure, pulmonary pneumonia and embolism. Medical statistics say that the life expectancy of patients after surgery increases from five years and above. After installation of the prosthesis, 60% of patients continue to live for an average of 15 years.

A favorable prognosis is grade 1 valve regurgitation. If there are no symptoms and heart failure, then there is no danger to life.

Preventive measures are based on the prevention of those diseases that can provoke regurgitation and dysfunction of the valve apparatus.

To summarize the article, it should be noted that it is important to have medical examinations conducted every year both in educational institutions and at work. Don't miss the opportunity to examine your body. The key to good health is systematic prevention.

And a little about secrets...

• Do you often experience discomfort in the heart area (stabbing or squeezing pain, burning sensation)?
• You may suddenly feel weak and tired...
• Blood pressure keeps going up...
• There is nothing to say about shortness of breath after the slightest physical exertion...
• And you have been taking a bunch of medications for a long time, going on a diet and watching your weight...

But judging by the fact that you are reading these lines, victory is not on your side. That is why we recommend that you familiarize yourself with new technique of Olga Markovich, which has found an effective remedy for the treatment of HEART diseases, atherosclerosis, hypertension and cleansing of blood vessels.

The valve apparatus of the heart is designed to maintain blood flow in the desired direction during heart contraction.

But as a result of valve damage (primary regurgitation), or expansion of the heart (secondary regurgitation), reverse outflow develops, leading after some time to heart failure.

The main causes of tricuspid insufficiency are:

This is a dysfunction of the heart valve.

The tricuspid valve connects the right atrium and the right ventricle of the heart.

It regulates the process of venous blood passage.

For the normal functioning of the heart, it is important that there is no backflow of blood.

But, with this disease, weakness of this valve manifests itself, which is expressed in the fact that some of the blood passes in the opposite direction.

Causes of the disease

Each valve, mitral, aortic and others, has its own role. The function of the tricuspid valve is to allow venous blood into the ventricle from the atrium.

During each contraction, a valve closes, allowing blood to flow from the stomach to the pulmonary artery. In addition, closing the valve prevents blood from flowing back into the atrium.

When the valve does not close completely, valve insufficiency develops.

Structure of the heart

Most often, tricuspid regurgitation is caused by dilatation of the right ventricle with disruption of the normal valve. This occurs in the following situations:

• pulmonary arterial hypertension which is caused by dysfunction of the main ventricle;
• heart failure;
• obstruction of the outflow tract of the pulmonary artery;
• infective endocarditis in drug addicts who make intravenous injections;
• carcinoid syndrome;
• rheumatic fever and so on.

In fact, there are not as few reasons as it might seem. Everything becomes clear after a thorough examination. After it, you can find out whether you are being accepted into the army with a certain diagnosis, although the most important thing is the treatment process.

There are several degrees of deficiency:

1. Tricuspid regurgitation 1st degree. In this case, the flow of blood from the valve walls into the atrium is barely detectable.
2. Grade 2 regurgitation indicates that the jet is within two centimeters.
3. Grade 3 regurgitation is determined by the length of the jet, which exceeds two centimeters.
4. Regurgitation of the 4th degree is characterized by a large extent in the right atrium.

We must not forget about such a concept as congenital tricuspid regurgitation. In infants, it manifests itself as supraventricular tachycardia or atrial fibrillation. Heart failure may develop later.

There are two types of this disease. They are called primary and secondary tricuspid regurgitation.

Symptoms

Severe regurgitation, if the structure of the heart differs from the norm, appears almost immediately after the birth of the baby. This can be expected if similar problems with the structure of the heart were identified during the examination of the fetus. Among the manifestations after birth the following can be noted:

• cyanosis;
• pancreatic failure;
• respiratory disorders.

Unfortunately, significant violations often result in death, so it is very important for every expectant mother to responsibly examine the fetus during pregnancy.

As already mentioned, symptoms of regurgitation occur infrequently in adults. Some patients note pulsation in the veins of the neck, which is associated with increased pressure in the jugular veins.

The only sign of severe or moderate regurgitation is swelling of the jugular veins. In this case, a pronounced smoothed c-v wave is observed, as well as a steep decrease in y. When regurgitation becomes severe, you can feel the right jugular veins trembling.

With small defects of the tricuspid valve leaflets, the disease does not manifest itself in any way, and thus it is considered to be a benign condition, which is not treated in all cases.

However, a small number of patients still experience pulsation of the neck veins, which is caused by increased pressure on them.

In severe cases, the patient may experience severe swelling of the jugular veins. With severe valve insufficiency, it ultimately leads to the formation of atrial flutter, right ventricular dysfunction, the formation of heart failure or atrial fibrillation.

With grade 2 tricuspid regurgitation, as with other degrees, the disease often occurs without obvious symptoms. In severe cases of the disease, the following manifestations are possible:

• Weakness, fatigue;
• Increased venous pressure, leading to swelling of the veins of the neck and their pulsation;
• Enlarged liver with characteristic pain in the right hypochondrium;
• Heart rhythm disturbances;
• Edema of the lower extremities.

Auscultation (listening) reveals a characteristic systolic murmur, best heard in the 5th–7th intercostal space from the left edge of the sternum, intensifying with inspiration, quiet and inconsistent.

With enlargement of the right ventricle and a large volume of blood entering it during diastole, a systolic murmur is also heard over the right jugular vein.

Due to the fact that problems appear in the main organ, which is responsible for the blood supply to the body, the consequences affect the entire human body.

To avoid serious complications, it is important to diagnose the deviation in time. To do this, you need to know the possible causes and signs of the disease.

The causes of tricuspid regurgitation can be different:

• consequences of heart attacks;
• valve insufficiency;
• tricuspid valve prolapse;
• rheumatic myocarditis;
• use of drugs and tobacco products.

The last statement is indirect, since the activity of the cardiovascular system deteriorates, which can subsequently cause many abnormalities, including the return of blood to the heart.

The second degree of this deviation differs from the first in that the length of the returning jet is longer and amounts to 2 cm. This interferes with the normal functioning of the heart. In addition, in the second degree, the ventricle begins to expand, and sounds become more obvious during examination.

If you experience the corresponding symptoms, it is recommended to undergo a heart examination to confirm or refute the suspected diagnosis. Reasons to see a doctor are:

• swelling of the neck and other parts of the body;
• shortness of breath with little physical activity;
• swelling of the veins in the neck;
• palpable heartbeat.

Due to the fact that blood flow deteriorates, problems with the movement of arms and legs and the appearance of chilliness (increased sensitivity to cold) in the extremities may occur.

How can you tell if you have tricuspid regurgitation? Usually the symptoms of this disease are subtle.

But, if you are careful enough, they can tell you whether you have this disease or not:

• One of the signs is the pulsation of swollen jugular (neck) veins.
• If there is a clearly visible pulsation that occurs in the left side of the chest, which can intensify during exhalation, then this is one of the symptoms of this disease.
• If there is pulsation in the liver area, you also need to be alert.
• If the legs swell, this indicates a weak flow of venous blood and can serve as one of the symptoms of tricuspid regurgitation.
• In rare cases, this may be a pulsation of the right atrium.
• One of the accompanying signs of this cardiac dysfunction may be rapid fatigue of the body and accompanying shortness of breath.
• Coldness of the limbs also indicates weak blood flow, which may well be one of the symptoms of this disease.
• One sign is frequent urination.
• If your stomach hurts, this may not indicate a disease of the digestive system, but a heart disease.
• A feeling of heaviness in the right hypochondrium can be an alarming sign.
• The skin can also give us one of the signals about the presence of the disease in question. If it has a yellowish tint, this may be an alarming sign.
• Pulmonary hypertension may indicate hypertension. This disease is expressed in increased blood pressure in the pulmonary artery.
• Dropsy of the abdomen is an accumulation of fluid either in the subcutaneous tissue or in the abdominal cavity. The disease is not only serious in itself, but can also be a sign of the disease discussed here.
• An enlarged liver can be a sign of various diseases, including this one.
• Enlargement of the right ventricle or atrium is one of the alarming signs.
• If a change in heart sounds occurs, this may signal a disease.
• If the disease occurs in a severe form, then in some cases trembling of the pulmonary artery may occur.
• If the disease is of rheumatic origin, it may be accompanied by aortic or mitral heart disease.
• Alarming symptoms may include certain heart murmurs: pansystolic, mesodiastolic or protodiastolic.

It is important to note that these symptoms cannot be considered mandatory. Rather, they can only be classified as possible. The fact is that it is not at all necessary that, during an illness, they will appear all at once. Some of them will appear, and some will not.

First-degree tricuspid regurgitation often resolves without any symptoms at all. During this phase of the disease, it can only be detected during electrocardiography.

Not only at this stage, but also in cases of second-degree disease, the patient often does not even know what is happening to him.

Diagnostics

Early diagnosis of the disease is very important for any person: for the fetus during a woman’s pregnancy, for a child, for those who are recruited into the army. It is necessary to identify the disease as early as possible and begin its treatment.

This is important for any type of regurgitation, be it mitral, tricuspid or other. Diagnostics helps to make an accurate diagnosis: tricuspid regurgitation of the 2nd degree, first or other.

But how exactly is this determined? Mild regurgitation in most situations is detected during echocardiography, which is performed for other reasons.

Overt or severe regurgitation is suggested by taking an anamnesis and performing a physical examination. The diagnosis is confirmed by Doppler echocardiography.

An electrocardiogram and chest x-ray are often performed. At the same time, the information provided by electrocardiography is quite normal.

Only in some situations are tall, sharp P waves detected, the appearance of which is due to the expansion of the right atrium. Tall R waves and some other symptoms may also be detected.

Chest x-rays often show good information, although the superior vena cava, right atrium, and RV contour may sometimes be enlarged.

In rare cases, cardiac catheterization is performed, for example, in order to evaluate the anatomy of the coronary vessels. In this case, a pronounced atrial systolic wave V during ventricular systole, as well as high or normal atrial systolic pressure, can be detected.

The main thing to remember is that you cannot be careless about your health; you need to do everything to prevent diseases or prevent them from developing, if you are regularly examined both during pregnancy to find out the condition of the fetus, and in case of any unwell health.

Moreover, doctors advise regular examinations even for those who do not feel any health problems, since some diseases, even such as tricuspid, mitral and other regurgitation, can occur without symptoms.

In order to diagnose and confirm the existing diagnosis, as well as determine the extent of the disease, Doppler echocardiography data is usually used for these purposes.

I would like to take into account that at the first stage of such a disease, the Virgo shows a reverse flow of blood from the right ventricle directly back to the right atrium.

The second degree is caused by reverse blood flow, but no more than 2 cm from the tricuspid valve. As for the third degree, the reverse blood flow exceeds 2 cm.

Ultimately, with the fourth degree, spread throughout the entire volume of the right atrium.

To diagnose tricuspid regurgitation, in addition to the history, physical examination and auscultation, the following studies are performed:

• ECG. The dimensions of the right ventricle and atrium, heart rhythm disturbances are determined;
• Phonocardiogram. The presence of systolic murmur is detected;
• Ultrasound of the heart. Signs of compaction of the valve walls, the area of ​​the atrioventricular orifice, and the degree of regurgitation are determined;
• Chest X-ray. The location of the heart and its size, signs of pulmonary hypertension are revealed;
• Catheterization of the heart cavities. The method is based on the introduction of catheters to determine the pressure in the cavities of the heart.

In addition, coronary angiocardiography can be used before surgery. It is based on the introduction of a contrast agent into the vessels and cavities of the heart to assess the movement of blood flow.

It is possible to make the correct diagnosis of tricuspid regurgitation, as well as determine the extent of the disease, based on Doppler echocardiography data.

With grade 1 tricuspid regurgitation, the reverse flow of blood from the right ventricle back into the right atrium is barely noticeable. Tricuspid regurgitation of the 2nd degree is characterized by reverse blood flow no more than 2.0 cm from the tricuspid valve.

With the third degree of insufficiency, regurgitation exceeds 2.0 cm, and with the fourth, it spreads throughout the entire volume of the right atrium.

Additional research methods include ECG and chest x-ray. An electrocardiogram often reveals signs of right ventricular hypertrophy.

Radiographs of grade 1 tricuspid regurgitation usually show no changes. With tricuspid regurgitation of grade 2 and higher, an enlarged shadow of the superior vena cava and right atrium is detected, and in some cases, the presence of effusion in the pleural cavity.

Cardiac catheterization as a diagnostic method for tricuspid valve regurgitation is extremely rare.

As a rule, grade 2 tricuspid regurgitation is a reason to take care of your heart health. Usually this problem is discovered quite quickly during examination, since this disease is a complication of other abnormalities.

For example, grade 2 tricuspid valve insufficiency in most cases leads to regurgitation. In this case, the deficiency itself must be treated.

In order to identify and diagnose the disease in question, you will need to undergo the following examinations:

1. 1. Echocardiography (EchoCG). There they listen to the heartbeat and use it to determine whether there is a deviation from the norm or not.
2. 2. Physical examination by a cardiologist. He directs for procedures. At the appointment, he will listen to the heartbeat, its tones and noises.
3. 3. Electrocardiography (ECG). This procedure is performed to detect dilation of the ventricle and atria, which is a sign of valve dysfunction.
4. 4. Breast X-ray. It refutes or confirms the previous point if there is any doubt.

In some cases (if equipment is available), catheterization may be performed to identify additional problems throughout the cardiovascular system. This is a relatively new examination method.

Tricuspid regurgitation of the 1st degree is a disease that rarely occurs as a single deviation. In most cases, it is a complication, and sometimes you can find a similar entry in a medical card: grade 1 tricuspid valve prolapse with grade 1 regurgitation.

Prolapse is one of the possible disturbances in the functioning of the valve, leading to regurgitation.

Treatment and prevention are prescribed only by a specialist. In most cases, tricuspid regurgitation is treated with special medications.

Sometimes exercise therapy in the form of walking in the fresh air or other activities may be prescribed to strengthen the heart muscle. It all depends on the characteristics of the human body and the degree of his disease.

And a little about secrets...

Have you ever suffered from HEART PAIN? Judging by the fact that you are reading this article, victory was not on your side. And of course you are still looking for a good way to get your heart functioning back to normal.

Then read what he says about this cardiologist with extensive experience Tolbuzina E.V. in his interview about natural ways to treat the heart and cleanse blood vessels.

Diagnosis plays a very important role in the treatment of this disease. In particular, in the initial stages, the disease can be detected only after undergoing an appropriate examination.

There are other reasons why this is important. The fact is that in the treatment process it is important to take into account all the features of a particular situation. We are talking not only about the degree of the disease, but also about the causes, about what cardiac pathologies occur simultaneously with this disease.

In this case, of course, it is also important to take into account the general condition of the patient. So, you decided to check if you have this disease. What should you do in this case to get an answer?

You need to undergo the following types of diagnostics:

1. First, the doctor must listen to how the heart works. We are talking about a physical examination.
2. Echocardiography using ultrasound will help to obtain detailed information about the functional and morphological state of the heart itself and its valves.
3. An electrocardiogram will make it possible to record an increase in the atrium and right ventricle.
4. Radiography for such a diagnosis will also provide important information. It will show whether the patient has pulmonary hypertension, and will also determine the enlargement of the right ventricle of the heart.
5. There is another procedure for diagnosing the heart, which began to be used relatively recently. This is cardiac catheterization. It is important to note that this procedure not only serves for diagnosis, but can also be used for medicinal purposes.
   This method involves moving a flexible tube through the blood vessels. The injection site is usually a vein or artery in the patient's arms or legs.

Treatment

Treatment is required when tricuspid regurgitation begins to manifest itself clinically, that is, from the second to the fourth degree. Conservative care consists of eliminating the underlying disease, as well as symptomatic therapy.

If treatment with medications does not bring results, and the degree of deficiency increases, then surgical intervention is recommended to the patient.

The main types of operations for this pathology are:

1. Valve replacement. Indicated for dysfunction of the valve due to its damage due to a defect or carcinoid syndrome. Recently, it has been practiced to take a pig valve for this purpose. This significantly reduces the likelihood of rejection and the development of embolic complications. Typically, after surgery, the patient feels well for 10 years. After which the valve wears out and requires repeated surgery.
2. Anuloplasty. It is performed when the opening between the right atrium and the ventricle widens.
3. Valve plastic surgery or suturing. It is also necessary for its destruction.

Preventive measures to prevent the development of tricuspid insufficiency include timely detection and treatment of diseases of the heart muscle.

It is difficult to make a prognosis for this pathology, since it rarely occurs in its pure form. Obviously, to determine the patient’s further quality of life and the degree of probability of death, one should take into account the general condition, age, and concomitant pathologies.

Regarding the consequences, it should be noted that everything depends on the specific diagnosis. Spontaneous overt tricuspid regurgitation is rare, so little information is available regarding prognosis.

Tricuspid valve regurgitation is most often well tolerated. Moreover, she does not need treatment. As to whether people with such a diagnosis are taken into the army or not, nothing precise can be said, since everything depends on the individual patient, his condition and accompanying diagnoses.

Today there are effective ways to combat conditions such as tricuspid, mitral regurgitation and its other manifestations. It is recommended to eliminate the causes of tricuspid regurgitation, that is, to treat, for example, inflammation of the inner lining of the heart, heart failure.

Surgery is indicated for patients who have a severe or moderate manifestation of the disease, as well as damage to the left-sided valves.

Surgery in such cases can prevent death, which results from poor cardiac function. Surgical treatment includes annuloplasty, where the valve ring is sutured to the prosthetic ring or the ring circumference is reduced.

This method is used if regurgitation is the result of annular dilatation.

Tricuspid regurgitation is a tricky disease that often hides under another mask. To prevent it from being very dangerous, it is necessary to be examined in time and follow the doctor’s prescriptions. Timely treatment and taking care of your health will help you avoid serious consequences!

Treatment of the defect can be carried out conservatively or surgically. The surgical method may be indicated already for grade 2 tricuspid regurgitation, if it is accompanied by heart failure or other pathologies.

With functional tricuspid regurgitation, the disease that caused the lesion is treated first.

During drug therapy, the following are prescribed: diuretics, vasodilators (drugs that relax the smooth muscles of the walls of blood vessels), potassium preparations, cardiac glycosides.

If conservative treatment is ineffective, surgical intervention is prescribed, including plastic surgery or annuloplasty and prosthetics.

Plastic surgeries, suture and semicircular annuloplasty are performed in the absence of changes in the valve leaflets and expansion of the fibrous ring to which they are attached.

Prosthetics are indicated for tricuspid valve insufficiency and extremely severe changes in its valves; prostheses can be biological or mechanical.

Biological prostheses created from animal aortas can function for more than 10 years, then the old valve is replaced with a new one.

With timely treatment of tricuspid regurgitation, the prognosis is favorable. After it is performed, patients must be regularly monitored by a cardiologist and undergo examinations to prevent complications.

Mild tricuspid regurgitation is well tolerated by people and does not require treatment. Therapy is usually prescribed for grade 2–4 tricuspid regurgitation.

First of all, it is aimed at eliminating the cause that led to the development of tricuspid valve insufficiency (treatment of rheumatism, septic endocarditis, etc.).

In addition, complications caused by tricuspid regurgitation - heart failure, arrhythmia - are also treated.

If there is no effect from the conservative treatment, as well as with further progression of valve insufficiency, surgical intervention is indicated - prosthetics, tricuspid valve repair or anuloplasty.

Anuloplasty is usually used in cases where the disease develops due to dilatation (widening) of the valve ring. Tricuspid valve replacement is indicated for valve insufficiency caused by Epstein's disease or carcinoid syndrome.

A porcine valve is used for the prosthesis, which can significantly reduce the likelihood of developing thromboembolic complications in the postoperative period. As practice shows, the pig valve functions effectively for more than 10 years, after which it is replaced with a new one.

Video from YouTube on the topic of the article:

The treatment tactics for regurgitation are determined by the cause that caused it, the degree of severity, the presence of heart failure and concomitant pathology.

Both surgical correction of structural abnormalities of the valves (various types of plastic surgery, prosthetics) and medical conservative therapy aimed at normalizing blood flow in the organs, combating arrhythmia and circulatory failure are possible.

Most patients with severe regurgitation and damage to both circulation circles require constant monitoring by a cardiologist, the prescription of diuretics, beta-blockers, antihypertensive and antiarrhythmic drugs, which will be selected by a specialist.

In case of low-grade mitral prolapse or prevalvular regurgitation of another localization, dynamic observation by a doctor and timely examination in case of worsening of the condition are sufficient.

The prognosis of valvular regurgitation depends on many factors: its degree, cause, age of the patient, presence of diseases of other organs, etc. With a caring attitude towards your health and regular visits to the doctor, minor regurgitation does not threaten complications, and in case of pronounced changes, their correction, including surgery, can prolong patients’ lives.

Display all posts with the tag:

Step 1: pay for the consultation using the form →
Step 2: after payment, ask your question in the form below ↓
Step 3: You can additionally thank the specialist with another payment for an arbitrary amount

1. Grade 1 tricuspid regurgitation usually does not require treatment. If the cause of the disease is infective endocarditis, pulmonary disease or rheumatic valve disease, then it is usually these concomitant diseases that are treated, and not triguspid regurgitation.
2. The second degree of the disease often also does not require treatment. If it is caused by one reason or another, that is what needs to be treated. Sometimes conservative treatment is still carried out.
   • Drugs for the treatment of tricuspid regurgitation come in two types: either diuretics (diuretics) or those that cause relaxation of the smooth muscles - the walls of blood vessels.
3. If the disease is of the third or fourth degree, then surgical treatment methods are used. Usually we are talking about three main methods: annuloplasty, valve repair and prosthetics.
   • The latter option is used only in extremely severe cases when other treatment methods do not work.
   • Valve surgery is the stitching of tissues so that there is no deformation of the valve.
   • Annuloplasty involves the installation of a metal support ring that will take some of the load on the heart valve.
4. Tricuspid regurgitation in a child of the first degree may not require treatment, but simply be an age-related change that will correct itself over time.

Possible complications, consequences

If proper treatment is not carried out, this can lead to serious consequences.

Diagnosis, prevention and treatment

• First of all, it is important to note that when diagnosing this disease, consulting a doctor plays an important role. This is due to the fact that only a professional can carry out competent and reliable diagnostics using special equipment designed for this purpose.
• It is also important to consider that this disease often occurs together with other cardiac disorders. They also need to be diagnosed.
• When treating, it is important to take into account the entire complex of specific circumstances. Complex treatment can only be of high quality under the supervision of a doctor.
Heart arrhythmia: causes, symptoms, diagnosis and treatment, how to relieve an attack of arrhythmia Symptoms, causes, methods of diagnosis and prevention, drug treatments for atherosclerosis and traditional medicine Fatty heart: causes and treatment Symptoms and treatment of the disease, possible complications and medications

Tricuspid regurgitation is one of the types of heart defects in which a backflow of blood occurs during systole from the right ventricle into the cavity of the right atrium. The reason for this is the incomplete closure of its valves. Tricuspid valve regurgitation can be acquired or congenital.

Origin of the term

The word "regurgitation" comes from the Latin gurgitare - "to flood" - and the prefix re-, denoting a reverse action, i.e. it implies a flow opposite to the normal direction. In this case, it is the reverse flow of blood.

Causes of congenital tricuspid regurgitation

The most common causes of this congenital pathology are:

• underdevelopment of valve leaflets;
• abnormal development (number) of valve leaflets;
• connective tissue dysplasia;
• Ehlers-Danlos syndrome;
• Marfan syndrome;
• Ebstein's anomaly.

Tricuspid regurgitation in the fetus is very rare in isolation; it is usually combined with other heart defects. This valve insufficiency may be part of the mitral-aortic-tricuspid defect.

Causes of acquired tricuspid regurgitation

Acquired tricuspid valve regurgitation is much more common than congenital regurgitation. It can be primary and secondary. The primary causes of this pathology include rheumatism, drug addiction, and carcinoid syndrome.

1. Rheumatism- This is the most common cause of this pathology. In 20% of cases, it is the recurrent one that leads to deformation (thickening and shortening) of the valve leaflets, and the tendon threads also change in the same way. Very often this pathology is accompanied by stenosis of the right atrioventricular orifice. This combination is called combined tricuspid defect.
2. Papillary muscle rupture may also lead to tricuspid regurgitation. Such ruptures occur during myocardial infarction or may have a traumatic origin.
3. Carcinoid syndrome can also lead to this pathology. It occurs in certain types of cancer, for example, cancer of the small intestine, ovaries or lungs.
4. Taking hard drugs very often leads to infective endocarditis, and this, in turn, can cause tricuspid regurgitation.

The most common causes of secondary tricuspid insufficiency are the following diseases:

• dilation of the annulus fibrosus, which occurs with dilated cardiomyopathy;
• high degree of pulmonary hypertension;
• weakness of the right ventricular myocardium, which occurs in the so-called cor pulmonale;
• chronic heart failure;
• myocarditis;
• myocardial dystrophy.

Symptoms in children

Congenital tricuspid regurgitation in infants in 25% of cases manifests itself as atrial fibrillation, later severe

In older children, even with minimal exertion, shortness of breath and palpitations appear. The child may complain of heart pain. Dyspeptic disorders (nausea, vomiting, flatulence) and pain or a feeling of heaviness in the right hypochondrium may be observed. If stagnation occurs in the systemic circulation, peripheral edema, ascites, hydrothorax or hepatomegaly appear. All these are very serious conditions.

Symptoms of the disease in adults

If this pathology is acquired at a later age, then at the initial stage a person may not even be aware of it. Minor tricuspid regurgitation is manifested only in some patients by pulsation of the jugular veins. The patient does not note any other symptoms. Grade 1 tricuspid valve regurgitation may not manifest itself in any way. Usually this pathology is discovered completely by accident during the next medical examination. The patient undergoes echocardiography, which reveals grade 1 tricuspid regurgitation. He will find out what it is only after examination. Such patients are usually registered with a cardiologist and monitored.

With more severe valve insufficiency, significant swelling of the jugular veins is observed. In this case, if you place your palm on the right side, you can feel it shaking. In severe cases, this pathology leads to right ventricular dysfunction, atrial fibrillation, or can provoke heart failure.

Diagnostics

The diagnosis of “grade 1 tricuspid regurgitation” or some other can be made only after a thorough examination of the patient. To do this, you must go through the following procedures:

• physical examination method, i.e. listening to heart sounds and murmurs with a stethoscope;
• EchoCG (echocardiography) is an ultrasound of the heart that reveals the functional and morphological state of the heart muscle and valves;
• ECG, in which you can see signs of an enlarged right atrium and ventricle of the heart;
• chest x-ray - this study also reveals an enlarged size of the right ventricle, signs of pulmonary hypertension and deformation of the mitral and aortic valves can be seen;
• perform a biochemical blood test;
• general blood analysis;
• Cardiac catheterization - this newest invasive procedure is used both for the diagnosis of cardiac pathologies and for treatment.

Classification

We found that tricuspid valve regurgitation can be congenital or acquired, primary (organic) or secondary (functional) by etiology. Organic failure is expressed by deformation of the valve apparatus: thickening and wrinkling of the valve leaflets or their calcification. Functional failure occurs when valve dysfunction is caused by other diseases and is manifested by rupture of the papillary muscles or chordae tendineae, as well as disruption of the annulus fibrosus.

Degrees of the disease

There are 4 degrees of this disease, which are characterized by the length of the return flow of blood into the cavity of the right atrium.

Tricuspid regurgitation 1st degree - what is it? In this case, the backflow of blood is insignificant and barely detectable. In this case, the patient does not complain about anything. There is no clinical picture.

With a diagnosis of “tricuspid regurgitation of the 2nd degree,” the reverse flow of blood is carried out within 2 cm of the valve walls. The clinical picture at this stage of the disease is almost absent; pulsation of the jugular veins may be weakly expressed.

Grade 3 tricuspid valve regurgitation is defined by backflow of blood more than 2 cm from the tricuspid valve. In addition to pulsation of the neck veins, patients may experience palpitations, weakness and fatigue; even with little physical exertion, slight shortness of breath may be observed.

Stage 4 disease is characterized by a pronounced backflow of blood over a long distance from the valve into the cavity of the right atrium. In severe cases, the patient may experience symptoms of severe heart failure and pulmonary hypertension (pulmonary and tricuspid regurgitation). In this case, the symptoms listed above are joined by others. Namely: swelling of the lower extremities, a feeling of pulsation on the left in the sternum, which intensifies with inspiration, disturbance of heart sounds, cold extremities, an increase in the size of the liver, ascites (accumulation of fluid in the abdominal cavity), abdominal pain, and with the rheumatic nature of this disease, it can be observed aortic or mitral valve disease.

Treatment

Treatment methods depend on the degree of the disease, as well as whether it is accompanied by other heart defects and pathologies or not. When diagnosed with grade 1 tricuspid valve regurgitation, no treatment is usually required. Doctors consider this condition as a variant of the norm. If grade 1 tricuspid regurgitation is caused by some disease, for example, lung disease, rheumatism, or the provoking disease should be treated. If you get rid of the underlying disease, further deformation of the tricuspid valve will stop. So, grade 1 tricuspid regurgitation - what it is and how to treat it is now clear. Let's consider the next stage of this disease.

Grade 2 tricuspid valve regurgitation often does not require treatment either. If this pathology is associated with other heart defects or diseases, for example, heart failure, then treatment must be carried out using conservative methods. To do this, diuretics are used to reduce swelling and drugs that relax the smooth muscles of the walls of blood vessels (vasodilators). Tricuspid regurgitation of the 2nd degree does not require any other measures.

Treatment of grades 3 and 4 is also aimed at eliminating the disease that caused the regurgitation. If it does not bring results, surgical intervention is indicated. In this case, plastic surgery of the valve leaflets, their annuloplasty (suturing an elastic or rigid ring, or suturing the valve ring by suturing) or prosthetics are provided.

Mitral regurgitation

In case of incompetence, when its valves do not close tightly enough, a reverse flow of blood occurs from the left ventricle into the cavity of the left atrium during systole. This condition is called mitral regurgitation or mitral valve prolapse. This pathology, like tricuspid regurgitation, can be either congenital or acquired. The causes and diagnosis of mitral and tricuspid regurgitation are also similar. There are only 4 degrees that determine the severity of the disease, they depend on the amount of reverse blood flow:

• 1st degree - mitral regurgitation is insignificant;
• 2nd degree - mitral regurgitation is moderate;
• 3rd degree - mitral regurgitation is significantly expressed;
• 4th degree - mitral regurgitation is severe, often complicated.

Minor mitral, tricuspid regurgitation of the 1st degree, which does not cause objective complaints in the patient, does not require any treatment. Therapeutic treatment is carried out for complicated course of the disease, for example, cardiac arrhythmias or pulmonary hypertension. Surgery is indicated for severe or severe mitral regurgitation; in these cases, valve surgery or replacement is performed.

Combination of mitral and tricuspid insufficiency

Often, mitral and tricuspid regurgitation are diagnosed simultaneously in one patient. After a detailed examination and receipt of test results, the cardiologist will decide on the treatment tactics for such a patient. If valve insufficiency is mild, no treatment may be needed, but you will need to be periodically observed by a cardiologist and undergo the necessary examinations.

If the cause of valve insufficiency is determined, therapeutic treatment will be prescribed aimed at eliminating the provoking disease. In the absence of positive dynamics, surgical treatment of regurgitation is indicated. This usually happens when the disease is severe and severe.

Patients who have undergone surgical treatment of valve insufficiency are usually prescribed indirect anticoagulants.

Forecast

Secondary regurgitation is considered the most unfavorable prognostically. The death of patients in this case usually occurs from myocardial infarction, increasing heart failure, pneumonia or pulmonary embolism.

According to statistics, after surgical treatment of heart valve insufficiency, the survival rate of patients up to 5 years or more is 65% after prosthetics and 70% after annuloplasty.

The prognosis is favorable with a diagnosis of grade 1 tricuspid regurgitation. Patients usually find out what it is only during preventive examinations. With minor heart valve insufficiency there is no direct threat to life.

Conclusion

Prevention of mitral and tricuspid insufficiency involves preventing diseases that provoke valve failure. Namely, the treatment of rheumatism and other diseases that cause damage to the heart valves.

Tricuspid valve regurgitation is often diagnosed in preschool children, and in adults it usually develops against the background of serious diseases of a wide variety of nature. This anomaly has several forms, different symptoms and, accordingly, different approaches to treatment.

The concept of tricuspid regurgitation

The term "regurgitation" is medical. It comes from the Latin word gurgitare (translated as “to flood”) and the prefix re-, meaning “again, back.” In cardiology, regurgitation is the reverse flow (reflux) of blood from one chamber of the heart to another.

The heart consists of four chambers (2 atria and 2 ventricles), separated by septa and equipped with four valves. These are the mitral, aortic, pulmonary artery and tricuspid (three-leaf). The latter connects the right ventricle and the right atrium. In each of the valves, for various reasons, blood flow disturbances can occur, which means that there are four types of this disease.

Aortic and mitral regurgitation are most often diagnosed; tricuspid regurgitation is slightly less common. But the danger is that during diagnosis one can confuse different forms of this pathology. In addition, sometimes disturbances in the functioning of different heart valves occur simultaneously in a patient.

An important point: tricuspid valve regurgitation is not an independent disease and a separate diagnosis. This condition usually develops due to other serious problems (heart, lung, etc.), and therefore is usually treated in combination. And most importantly, an anomaly with a frightening Latin name should not be considered a death sentence. It is quite easy to diagnose, it is quite possible to cure or at least strictly control it.

Types of tricuspid regurgitation

There are 2 main classifications of this pathology - according to the time of appearance and the reasons for its occurrence.

• By time of appearance: congenital and acquired.

Congenital is registered during the intrauterine development of the child or in the first months after birth. In this case, heart valve function may return to normal over time. In addition, it is much easier to keep a congenital anomaly under control if you take care of the heart and follow measures to prevent cardiovascular diseases.

Acquired disease appears in adults already during life. This pathology almost never occurs in isolation; it can be caused by a variety of diseases - from dilatation (expansion) of the ventricle to obstruction of the pulmonary arteries.

Primary tricuspid anomaly is diagnosed against the background of heart disease. The patient does not have any problems with the respiratory system with this diagnosis. The main cause of secondary disruption of blood flow in the tricuspid valve is pulmonary hypertension, that is, too high pressure in the pulmonary artery system.

Regurgitation of the tricuspid valve traditionally goes hand in hand with insufficiency of the valve itself. Therefore, some classifications divide the types of reverse blood flow based on the form of tricuspid insufficiency, that is, the valve disease itself:

1. Organic (absolute) failure, when the cause is damage to the valve leaflets due to a congenital disease.
2. Functional (relative), when the valve is stretched due to problems with the pulmonary vessels or diffuse damage to the cardiac tissue.

Degrees of tricuspid valve regurgitation

Regurgitation can occur in 4 different stages (degrees). But sometimes doctors identify a separate, fifth, so-called physiological regurgitation. In this case, there are no changes in the myocardium, all three valve leaflets are completely healthy, there is simply a barely noticeable disturbance in the blood flow at the leaflets themselves (“swirling” of the blood).

• First stage. In this case, the patient experiences a small flow of blood back, from the ventricle into the atrium through the valve leaflets.
• Second stage. The length of the jet from the valve reaches 20 mm. Tricuspid regurgitation of the 2nd degree is already considered a disease that requires special treatment.
• Third stage. Blood flow is easily detected during diagnosis and is greater than 2 cm in length.
• Fourth stage. Here the blood flow already goes a considerable distance deep into the right atrium.

Functional tricuspid regurgitation is usually graded as grade 0–1. Most often it is found in tall, thin people, and some medical sources report that 2/3 of absolutely healthy people have this anomaly.

This condition is absolutely not life-threatening, does not affect well-being in any way, and is discovered during examination by chance. Unless, of course, it starts to progress.

Causes of pathology

The main cause of impaired blood flow through the tricuspid valve is dilatation of the right ventricle along with valvular insufficiency. This anomaly is provoked by pulmonary hypertension, heart failure, obstruction (obstruction) of the pulmonary arteries. Less common causes of blood reflux are infective endocarditis, rheumatism, medication, etc.

The factors that cause the appearance of this heart disease are usually divided into 2 large groups depending on the type of pathology itself:

1. Causes of primary tricuspid regurgitation:
   • rheumatism (systemic inflammation of connective tissue);
   • infective endocarditis (inflammation of the endocardium, often found in injection drug users);
   • valve prolapse (the valves bend by several millimeters);
   • Marfan syndrome (hereditary connective tissue disease);
   • Ebstein's anomalies (a congenital defect in which the valve leaflets are displaced or absent);
   • chest injuries;
   • long-term use of medications (Ergotamine, Phentermine, etc.).
2. Causes of secondary tricuspid regurgitation:

• increased pressure in the pulmonary arteries (hypertension);
• enlargement or hypertrophy of the right ventricle;
• right ventricular dysfunction;
• mitral valve stenosis;
• failure of the right and severe failure of the left ventricle;
• various types of cardiopathy;
• atrial septal defect (congenital defect);
• obstruction of the pulmonary artery (and its outflow tract).

Symptoms

In mild forms of impaired blood flow between the chambers of the heart, there are no specific symptoms.

Tricuspid regurgitation of the 1st degree can manifest itself only by one sign - increased pulsation of the veins in the neck.

This effect occurs due to high pressure in the jugular veins, and it is easy to feel the pulsation by simply placing your hand on the right side of the neck.

In later stages, you can feel not only a beating pulse, but also a clear trembling of the neck veins. The following symptoms will indicate problems with blood flow in the right ventricle:

• the jugular veins not only tremble, but also swell noticeably;
• bluish skin color (primarily on the nasolabial triangle, under the nails, on the lips and tip of the nose);
• swelling of the legs;
• atrial fibrillation;
• splitting of heart sounds;
• holosystolic heart murmur (increases with inspiration);
• shortness of breath and fatigue;
• pain and heaviness in the right hypochondrium;
• enlarged liver, etc.

Most of these signs can signal a variety of problems with the cardiovascular system. Therefore, the clearest visible symptom of tricuspid regurgitation is the swelling and trembling of the jugular vein.

Tricuspid regurgitation in children

Reverse reflux of blood into the right ventricle is now increasingly being recorded in children, even before birth. Tricuspid regurgitation in the fetus can appear in the first trimester of pregnancy, at 11–13 weeks.

This feature often occurs in babies with chromosomal abnormalities (for example, Down syndrome). But a certain percentage of regurgitation is also observed in an absolutely healthy fetus.

Pediatric cardiologists report a rapidly growing number of cases of tricuspid anomaly in children of different ages. In most of them, regurgitation of the first degree is diagnosed, and today it is already considered a normal variant.

If the child does not have other heart pathologies, in the future there is a high chance that the valve will work on its own.

But if the congenital disease reaches the second or third stage, there is a risk of developing heart failure and right ventricular dysfunction in the future. Therefore, it is important for your child to regularly visit a cardiologist and follow all necessary measures to prevent heart disease.

Diagnostics

Doctors learned to identify severe tricuspid regurgitation a long time ago, but diagnosing mild forms became possible relatively recently, with the advent of ultrasound. That is about 40 years ago.

Today, ultrasound is considered the main diagnostic method for this pathology. It allows you to distinguish the slightest opening of the valve flaps, the size and direction of the blood stream.

A comprehensive diagnosis of tricuspid valve regurgitation includes the following:

• taking anamnesis;
• physical examination (including cardiac auscultation - listening);
• Ultrasound of the heart (regular and with Doppler) or echocardiography;
• electrocardiography;
• chest x-ray;
• cardiac catheterization.

Catheterization is a diagnostic and therapeutic method that requires careful preparation of the patient. It is rarely used to study problems with blood flow through the tricuspid valve. Only in cases where the most in-depth diagnostics are required, for example, to assess the condition of the coronary vessels of the heart.

Treatment and prevention

Therapy for tricuspid regurgitation includes 2 large blocks - conservative and surgical treatment. When the disease is in the first stage, no special therapy is required, only regular monitoring by a cardiologist.

If the patient has cardiovascular pathologies that provoked a disturbance in blood flow, all treatment is aimed specifically at them, that is, at eliminating the cause of regurgitation.

When the disease reaches the second stage, conservative treatment already involves taking special medications. These are diuretics (diuretic), vasodilators (agents for relaxing the muscles of blood vessels), potassium supplements, etc.

Surgical treatment of the tricuspid valve includes the following types of operations:

The prognosis for life with tricuspid regurgitation is quite favorable, provided that the patient leads a healthy lifestyle and takes care of his heart. And when the disease is detected at the very first stage, and when valve surgery has already been performed.

In this case, doctors advise using standard measures to prevent heart failure. These include body weight control and regular physical activity, proper nutrition, giving up cigarettes and alcohol, regular rest and as little stress as possible. And most importantly, constant monitoring by a cardiologist.

• Diseases
• Body parts

A subject index to common diseases of the cardiovascular system will help you quickly find the material you need.

Select the body part you are interested in, the system will show materials related to it.

© Prososud.ru Contacts:

Use of site materials is possible only if there is an active link to the source.

Tricuspid regurgitation

Tricuspid regurgitation is one of the types of heart defects in which there is insufficiency of the tricuspid (tricuspid) valve, leading during systole to the reverse flow of blood from the right ventricle into the atrium.

Tricuspid regurgitation: causes

Most often, the development of tricuspid valve regurgitation occurs against the background of heart disease, occurring with dilatation of the right ventricle and pulmonary hypertension. Much less frequently, this disease occurs against the background of septic endocarditis, rheumatism, carcinoid syndrome, and Marfan syndrome. Tricuspid valve insufficiency can be a congenital pathology or develop as a result of long-term use of certain medications (phentermine, fenfluramine, ergotamine).

Symptoms

With a minor defect of the tricuspid valve leaflets (grade 1 tricuspid regurgitation), the disease usually does not manifest itself in any way and is considered a benign condition for which no treatment is carried out. Only a small proportion of patients experience pulsation of the neck veins caused by increased pressure in them.

In severe tricuspid regurgitation, marked swelling of the jugular veins is observed. By placing your hand on the right jugular vein, you can feel it trembling. Significant valve insufficiency can lead to right ventricular dysfunction, atrial flutter or atrial fibrillation, and the formation of heart failure.

Tricuspid regurgitation: diagnosis

It is possible to make the correct diagnosis of tricuspid regurgitation, as well as determine the extent of the disease, based on Doppler echocardiography data. With grade 1 tricuspid regurgitation, the reverse flow of blood from the right ventricle back into the right atrium is barely noticeable. Tricuspid regurgitation of the 2nd degree is characterized by reverse blood flow no more than 2.0 cm from the tricuspid valve. With the third degree of insufficiency, regurgitation exceeds 2.0 cm, and with the fourth, it spreads throughout the entire volume of the right atrium.

Additional research methods include ECG and chest x-ray. An electrocardiogram often reveals signs of right ventricular hypertrophy. Radiographs of grade 1 tricuspid regurgitation usually show no changes. With tricuspid regurgitation of grade 2 and higher, an enlarged shadow of the superior vena cava and right atrium is detected, and in some cases, the presence of effusion in the pleural cavity.

Cardiac catheterization as a diagnostic method for tricuspid valve regurgitation is extremely rare.

Treatment of tricuspid regurgitation

Mild tricuspid regurgitation is well tolerated by people and does not require treatment. Therapy is usually prescribed for grade 2–4 tricuspid regurgitation. First of all, it is aimed at eliminating the cause that led to the development of tricuspid valve insufficiency (treatment of rheumatism, septic endocarditis, etc.). In addition, complications caused by tricuspid regurgitation - heart failure, arrhythmia - are also treated.

If there is no effect from the conservative treatment, as well as with further progression of valve insufficiency, surgical intervention is indicated - prosthetics, tricuspid valve repair or anuloplasty.

Anuloplasty is usually used in cases where the disease develops due to dilatation (widening) of the valve ring. Tricuspid valve replacement is indicated for valve insufficiency caused by Epstein's disease or carcinoid syndrome. A porcine valve is used for the prosthesis, which can significantly reduce the likelihood of developing thromboembolic complications in the postoperative period. As practice shows, the pig valve functions effectively for more than 10 years, after which it is replaced with a new one.

Video from YouTube on the topic of the article:

The information is generalized and is provided for informational purposes. At the first signs of illness, consult a doctor. Self-medication is dangerous to health!

I hope you don’t seriously think that the decision about the need for heart surgery is made on the Internet based on a two-sentence description. You need an in-person consultation with a cardiologist.

If you have complaints, you should consult with another cardiologist. It is also advisable to take a blood test to rule out anemia.

And if a child has the flu or a sore throat, will you also send him to an orphanage so that there are no problems? Tricuspid regurgitation of the 1st degree does not pose a serious problem, and in most cases it does not require treatment either. The doctor couldn't say such nonsense.

Good afternoon, Tasya555.

Good afternoon, Tasya555.

Indeed, there is no particular danger, but consultation with a cardiologist is necessary, and periodic examination is also required.

THANK YOU. We are going to see a cardiologist.

The highest body temperature was recorded in Willie Jones (USA), who was admitted to the hospital with a temperature of 46.5°C.

Each person has not only unique fingerprints, but also tongue prints.

It was previously believed that yawning enriches the body with oxygen. However, this opinion has been refuted. Scientists have proven that yawning cools the brain and improves its performance.

The rarest disease is Kuru disease. Only members of the For tribe in New Guinea suffer from it. The patient dies of laughter. The disease is believed to be caused by eating human brains.

Besides people, only one living creature on planet Earth suffers from prostatitis - dogs. These are truly our most faithful friends.

People who eat breakfast regularly are much less likely to be obese.

In order to say even the shortest and simplest words, we use 72 muscles.

More than $500 million a year is spent on allergy medications in the United States alone. Do you still believe that a way to finally defeat allergies will be found?

Most women are able to derive more pleasure from contemplating their beautiful body in the mirror than from sex. So, women, strive to be slim.

Many drugs were initially marketed as medicines. Heroin, for example, was originally brought to market as a cure for children's coughs. And cocaine was recommended by doctors as an anesthesia and as a means of increasing endurance.

Dentists appeared relatively recently. Back in the 19th century, pulling out diseased teeth was the responsibility of an ordinary hairdresser.

Our kidneys are capable of purifying three liters of blood in one minute.

According to many scientists, vitamin complexes are practically useless for humans.

A person taking antidepressants will, in most cases, become depressed again. If a person has coped with depression on his own, he has every chance to forget about this condition forever.

The first vibrator was invented in the 19th century. It was powered by a steam engine and was intended to treat female hysteria.

An infectious inflammatory process in the kidneys associated with the development of bacteria in the urinary system is called pyelonephritis. This serious illness is observed in...

Heart valve regurgitation: symptoms, degrees, diagnosis, treatment

The term “regurgitation” is quite often used by doctors of various specialties - cardiologists, therapists, functional diagnosticians. Many patients have heard it more than once, but have little idea what it means and what it threatens. Should we be afraid of having regurgitation and how to treat it, what consequences to expect and how to identify it? Let's try to find out these and many other questions.

Regurgitation is nothing more than the reverse flow of blood from one chamber of the heart to another. In other words, during contraction of the heart muscle, a certain volume of blood, for various reasons, returns to the cavity of the heart from which it came. Regurgitation is not an independent disease and therefore is not considered a diagnosis, but it characterizes other pathological conditions and changes (heart defects, for example).

Since blood continuously moves from one part of the heart to another, coming from the vessels of the lungs and leaving for the systemic circulation, the term “regurgitation” applies to all four valves on which reverse flow may occur. Depending on the volume of blood that returns, it is customary to distinguish the degrees of regurgitation that determine the clinical manifestations of this phenomenon.

A detailed description of regurgitation, identification of its degrees and detection in a large number of people became possible with the use of ultrasound examination of the heart (echocardiography), although the concept itself has been known for quite a long time. Listening to the heart provides subjective information, and therefore does not allow one to judge the severity of the return of blood, while the presence of regurgitation is not in doubt except in severe cases. The use of ultrasound with Doppler makes it possible to see in real time the contractions of the heart, how the valve flaps move and where the blood stream rushes.

Briefly about anatomy...

In order to better understand the essence of regurgitation, it is necessary to recall some aspects of the structure of the heart, which most of us conveniently forgot, having once studied in biology lessons at school.

The heart is a hollow muscular organ with four chambers (two atria and two ventricles). Between the chambers of the heart and the vascular bed there are valves that function as “gates”, allowing blood to pass in only one direction. This mechanism ensures adequate blood flow from one circle to another due to the rhythmic contraction of the heart muscle, which pushes blood inside the heart and into the vessels.

The mitral valve is located between the left atrium and the ventricle and consists of two leaflets. Since the left half of the heart is the most functionally burdened, works under heavy load and under high pressure, it is often here that various malfunctions and pathological changes occur, and the mitral valve is often involved in this process.

The tricuspid, or tricuspid, valve lies on the path from the right atrium to the right ventricle. It is already clear from its name that anatomically it consists of three interlocking valves. Most often, its damage is secondary in nature to an existing pathology of the left side of the heart.

The valves of the pulmonary artery and aorta each have three valves and are located at the junction of these vessels with the cavities of the heart. The aortic valve is located on the path of blood flow from the left ventricle to the aorta, and the pulmonary artery - from the right ventricle to the pulmonary trunk.

In the normal state of the valve apparatus and myocardium, at the moment of contraction of one or another cavity, the valve leaflets close tightly, preventing the reverse flow of blood. With various heart lesions, this mechanism may be disrupted.

Sometimes in the literature and in doctors’ reports you can find references to the so-called physiological regurgation, which means a slight change in blood flow at the valve leaflets. In fact, in this case, a “swirl” of blood occurs at the valve opening, and the leaflets and myocardium are completely healthy. This change does not affect blood circulation in general and does not cause clinical manifestations.

Physiological can be considered regurgitation of 0-1 degree on the tricuspid valve, at the mitral valves, which is often diagnosed in thin, tall people, and according to some data, is present in 70% of healthy people. This feature of blood flow in the heart does not in any way affect your well-being and can be detected by chance during an examination for other diseases.

As a rule, pathological reverse blood flow through the valves occurs when their valves do not close tightly at the moment of myocardial contraction. The reasons may be not only damage to the leaflets themselves, but also to the papillary muscles, chordae tendineae involved in the mechanism of valve movement, stretching of the valve ring, and pathology of the myocardium itself.

Mitral regurgitation

Mitral regurgitation is clearly observed with valve insufficiency or prolapse. At the moment of contraction of the left ventricular muscle, a certain volume of blood returns to the left atrium through an insufficiently closed mitral valve (MV). At the same moment, the left atrium fills with blood flowing from the lungs through the pulmonary veins. This flooding of the atrium with excess blood leads to overdistension and increased pressure (volume overload). Excess blood during contraction of the atria enters the left ventricle, which is forced to push more blood into the aorta with greater force, as a result of which it thickens and then expands (dilatation).

For some time, disturbances in intracardiac hemodynamics may remain invisible to the patient, since the heart, as best it can, compensates for blood flow due to the expansion and hypertrophy of its cavities.

With mitral regurgitation of the 1st degree, there are no clinical signs for many years, and with a significant volume of blood returning to the atrium, it expands, the pulmonary veins become filled with excess blood and signs of pulmonary hypertension appear.

Among the causes of mitral regurgitation, which is the second most common acquired heart defect after changes in the aortic valve, we can highlight:

• Rheumatism;
• Prolapse;
• Atherosclerosis, deposition of calcium salts on the valves of the mitral valve;
• Some connective tissue diseases, autoimmune processes, metabolic disorders (Marfan syndrome, rheumatoid arthritis, amyloidosis);
• Coronary heart disease (especially infarction with damage to the papillary muscles and chordae tendineae).

With mitral regurgitation of the 1st degree, the only sign may be the presence of a murmur in the area of ​​the apex of the heart, detected by auscultation, while the patient has no complaints, and there are no manifestations of circulatory disorders. Echocardiography (ultrasound) can detect slight divergence of the leaflets with minimal disruption of blood flow.

Mitral valve regurgitation of the 2nd degree accompanies a more pronounced degree of insufficiency, and the stream of blood returning back to the atrium reaches its middle. If the amount of blood return exceeds a quarter of the total amount located in the cavity of the left ventricle, then signs of stagnation in the small circle and characteristic symptoms are detected.

The third degree of regurgitation is said to occur when, in the case of significant defects of the mitral valve, the blood flowing back reaches the posterior wall of the left atrium.

When the myocardium cannot cope with the excess volume of contents in the cavities, pulmonary hypertension develops, leading, in turn, to overload of the right half of the heart, resulting in circulatory failure in the systemic circle.

With grade 4 regurgitation, characteristic symptoms of severe disturbances in blood flow inside the heart and increased pressure in the pulmonary circulation are shortness of breath, arrhythmias, and the possible occurrence of cardiac asthma and even pulmonary edema. In advanced cases of heart failure, signs of damage to the pulmonary bloodstream include swelling, cyanosis of the skin, weakness, fatigue, a tendency to arrhythmias (atrial fibrillation), and pain in the heart. In many ways, the manifestations of severe mitral regurgitation are determined by the disease that led to damage to the valve or myocardium.

Separately, it is worth mentioning about mitral valve prolapse (MVP), quite often accompanied by regurgitation of varying degrees. In recent years, prolapse has begun to appear in diagnoses, although previously such a concept was quite rare. This state of affairs is largely due to the advent of imaging methods - ultrasound examination of the heart, which makes it possible to trace the movement of the valves of the MV during cardiac contractions. With the use of Doppler, it became possible to determine the exact degree of blood return to the left atrium.

MVP is typical for tall, thin people; it is often discovered accidentally in adolescents during examination before conscription into the army or undergoing other medical examinations. Most often, this phenomenon is not accompanied by any disturbances and does not in any way affect the lifestyle and well-being, so you should not be alarmed right away.

Mitral valve prolapse with regurgitation is not always detected; its degree in most cases is limited to the first or even zero, but at the same time, this feature of the functioning of the heart can be accompanied by extrasystole and disturbances in the conduction of nerve impulses through the myocardium.

If low-grade MVP is detected, you can limit yourself to observation by a cardiologist, and treatment is not required at all.

Aortic regurgitation

Reverse blood flow on the aortic valve occurs when it is insufficient or the initial part of the aorta is damaged, when, in the presence of an inflammatory process, its lumen and the diameter of the valve ring expand. The most common reasons for such changes are:

• Rheumatic lesions;
• Infectious endocarditis with inflammation of the leaflets, perforation;
• Congenital malformations;
• Inflammatory processes of the ascending aorta (syphilis, aortitis with rheumatoid arthritis, ankylosing spondylitis, etc.).

Such common and well-known diseases as arterial hypertension and atherosclerosis can also lead to changes in the valve leaflets, aorta, and left ventricle of the heart.

Aortic regurgitation is accompanied by the return of blood to the left ventricle, which becomes overfilled with excess volume, while the amount of blood entering the aorta and further into the systemic circulation may decrease. The heart, trying to compensate for the lack of blood flow and pushing excess blood into the aorta, increases in volume. For a long time, especially with stage 1 regurgitation, such an adaptive mechanism allows maintaining normal hemodynamics, and symptoms of disorders do not occur for many years.

As the mass of the left ventricle increases, its need for oxygen and nutrients, which the coronary arteries are unable to provide, also increases. In addition, the amount of arterial blood pushed into the aorta becomes less and less, and, therefore, it will not flow enough into the vessels of the heart. All this creates the preconditions for hypoxia and ischemia, resulting in cardiosclerosis (overgrowth of connective tissue).

As aortic regurgitation progresses, the load on the left half of the heart reaches its maximum degree, the myocardial wall cannot hypertrophy indefinitely and it stretches. Subsequently, events develop in the same way as with damage to the mitral valve (pulmonary hypertension, congestion in the small and large circles, heart failure).

Patients may complain of palpitations, shortness of breath, weakness, and pallor. A characteristic feature of this defect is the appearance of angina attacks associated with inadequacy of coronary circulation.

Tricuspid regurgitation

Isolated lesions of the tricuspid valve (TC) are quite rare. As a rule, its insufficiency with regurgitation is a consequence of pronounced changes in the left half of the heart (relative TC insufficiency), when high pressure in the pulmonary circulation prevents adequate cardiac output into the pulmonary artery, which carries blood for oxygenation into the lungs.

Tricuspid regurgitation leads to disruption of complete emptying of the right half of the heart, adequate venous return through the vena cava and, accordingly, congestion appears in the venous part of the systemic circulation.

For tricuspid valve insufficiency with regurgitation, the occurrence of atrial fibrillation, cyanosis of the skin, edematous syndrome, swelling of the neck veins, enlarged liver and other signs of chronic circulatory failure are quite typical.

Pulmonary valve regurgitation

Damage to the pulmonary valve leaflets can be congenital, manifesting itself in childhood, or acquired as a result of atherosclerosis, syphilitic lesions, or changes in the leaflets due to septic endocarditis. Often, damage to the pulmonary valve with insufficiency and regurgitation occurs with existing pulmonary hypertension, lung diseases, and damage to other heart valves (mitral stenosis).

Minimal regurgitation on the pulmonary valve does not lead to significant hemodynamic disorders, while a significant return of blood to the right ventricle, and then to the atrium, causes hypertrophy and subsequent dilatation (expansion) of the cavities of the right half of the heart. Such changes are manifested by severe heart failure in the systemic circle and venous stagnation.

Pulmonary regurgitation is manifested by all kinds of arrhythmias, shortness of breath, cyanosis, severe edema, accumulation of fluid in the abdominal cavity, changes in the liver up to cirrhosis and other signs. With congenital valve pathology, symptoms of circulatory disorders occur already in early childhood and are often irreversible and severe.

Features of regurgitation in children

In childhood, the proper development and functioning of the heart and circulatory system is very important, but disorders, unfortunately, are not uncommon. Most often, valve defects with insufficiency and return of blood in children are caused by congenital developmental anomalies (tetralogy of Fallot, hypoplasia of the pulmonary valve, defects of the septa between the atria and ventricles, etc.).

Severe regurgitation with an abnormal structure of the heart manifests itself almost immediately after the birth of a child with symptoms of respiratory distress, cyanosis, and right ventricular failure. Often, significant violations end fatally, so every expectant mother needs to not only take care of her health before the intended pregnancy, but also promptly visit an ultrasound diagnostic specialist during pregnancy.

Possibilities of modern diagnostics

Medicine does not stand still, and the diagnosis of diseases is becoming more reliable and of high quality. The use of ultrasound has made significant progress in detecting a number of diseases. The addition of ultrasound examination of the heart (EchoCG) with Dopplerography makes it possible to assess the nature of blood flow through the vessels and cavities of the heart, the movement of valve leaflets at the time of myocardial contractions, establish the degree of regurgitation, etc. Perhaps EchoCG is the most reliable and informative method for diagnosing cardiac pathology in the mode real time and at the same time being accessible and inexpensive.

mitral regurgitation on echocardiography

In addition to ultrasound, indirect signs of regurgitation can be detected on an ECG, with careful auscultation of the heart and assessment of symptoms.

It is extremely important to identify disorders of the heart valve apparatus with regurgitation not only in adults, but also during fetal development. The practice of ultrasound examination of pregnant women at different stages makes it possible to detect the presence of defects that are beyond doubt even during the initial examination, as well as to diagnose regurgitation, which is an indirect sign of possible chromosomal abnormalities or developing valve defects. Dynamic observation of women at risk makes it possible to timely establish the presence of serious pathology in the fetus and resolve the issue of the advisability of continuing pregnancy.

Treatment

The treatment tactics for regurgitation are determined by the cause that caused it, the degree of severity, the presence of heart failure and concomitant pathology.

Both surgical correction of structural abnormalities of the valves (various types of plastic surgery, prosthetics) and medical conservative therapy aimed at normalizing blood flow in the organs, combating arrhythmia and circulatory failure are possible. Most patients with severe regurgitation and damage to both circulation circles require constant monitoring by a cardiologist, the prescription of diuretics, beta-blockers, antihypertensive and antiarrhythmic drugs, which will be selected by a specialist.

In case of low-grade mitral prolapse or prevalvular regurgitation of another localization, dynamic observation by a doctor and timely examination in case of worsening of the condition are sufficient.

The prognosis of valvular regurgitation depends on many factors: its degree, cause, age of the patient, the presence of diseases of other organs, etc. With a caring attitude towards your health and regular visits to the doctor, minor regurgitation does not threaten complications, and with pronounced changes, their correction, including including surgical, allows you to prolong the life of patients.