Tricuspid Valve Disease: Causes, Symptoms, And Treatment

What Is Tricuspid Valve Disease?

Tricuspid valve disease refers to any condition that impairs the normal function of the tricuspid valve—the valve located between the right atrium and right ventricle of the heart. This valve plays a crucial role in maintaining one-way blood flow from the right atrium to the right ventricle. When the tricuspid valve does not open or close properly, blood flow becomes inefficient, placing strain on the right side of the heart and potentially leading to right-sided heart disease.

Although tricuspid valve disease is less common than left-sided valve disorders, untreated disease can significantly impair heart function.

Role of the Tricuspid Valve in the Heart

The tricuspid valve directs deoxygenated blood from the right atrium into the right ventricle, which then pumps it to the lungs for oxygenation. With each heartbeat, the valve opens to allow blood flow and closes tightly to prevent backflow. Any structural or functional abnormality of this valve disrupts normal circulation, causing venous congestion and organ enlargement.

Types of Tricuspid Valve Disease

Tricuspid valve disease mainly occurs in two forms:

a. Tricuspid Regurgitation (TR)

Tricuspid regurgitation occurs when the valve does not close completely, allowing blood to leak backwards into the right atrium. This is the most common form of tricuspid valve disorder and often develops as a secondary condition due to enlargement of the right ventricle.

b. Tricuspid Stenosis (TS)

Tricuspid stenosis is a narrowing of the valve opening, which restricts blood flow from the right atrium to the right ventricle. This condition is less common and is often associated with rheumatic heart disease.

Primary vs Secondary Tricuspid Valve Disease

Causes of Tricuspid Valve Disease

Common causes of tricuspid valve disease include:

• Rheumatic heart disease
• Congenital abnormalities or birth defects
• Infective endocarditis
• Carcinoid syndrome
• Trauma or previous heart surgery
• Pacemaker or catheter-related injury

Risk Factors for Tricuspid Valve Disease

Key risk factors associated with Tricuspid valve disease are:

• History of rheumatic fever
• Chronic lung disease
• Pulmonary hypertension
• Previous heart valve surgery
• Intravenous drug use
• Presence of a heart murmur

Symptoms of Tricuspid Valve Disease

Most commonly observed symptoms of tricuspid valve disease include::

• Fatigue and weakness
• Swelling of legs, ankles, or abdomen
• Shortness of breath
• Palpitations
• Reduced exercise capacity or tolerance

Early vs Advanced Symptoms

Tricuspid Valve Disease and Right-Sided Heart Failure

Untreated tricuspid valve disease can progress to right-sided heart failure. When the right ventricle cannot pump effectively, blood backs up into the veins, causing fluid retention in the legs, abdomen, and other tissues—often worsening gradually and reducing day-to-day quality of life.

According to Circulation (American Heart Association), untreated moderate to severe tricuspid regurgitation is independently associated with increased morbidity and mortality with higher morbidity and mortality, highlighting the need for timely evaluation with comprehensive imaging, right ventricular function assessment, and appropriate surgical or transcatheter intervention in symptomatic patients.

How Tricuspid Valve Disease Is Diagnosed

Diagnosis of tricuspid valve disease involves the following steps:

• Physical examination and auscultation
• Medical history review
• Blood tests to assess overall health
• Imaging studies

Echocardiography in Tricuspid Valve Disease

Echocardiography is the primary diagnostic tool for tricuspid valve disease. It provides real-time images of valve structure, blood flow direction, and severity of regurgitation or stenosis. Doppler echocardiography helps quantify pressure changes and valve dysfunction accurately.

Other Tests Used for Diagnosis

• Cardiac MRI for detailed heart structure and right ventricle assessment
• Cardiac CT/CT angiography for 3D valve anatomy and procedural planning
• Right heart catheterisation to directly measure right-sided pressures and cardiac output
• Exercise stress test to assess functional capacity and symptom correlation
• Liver function tests (AST, ALT) may be ordered when liver congestion is suspected
• Renal Function Test (RFT), including GFR (Creatinine-based) and Cystatin C, when fluid overload or diuretics may affect kidney function

Severity Grading of Tricuspid Valve Disease

Severity is classified as mild, moderate, or severe based on echocardiographic parameters, symptom severity, and effects on heart chamber size and function. Accurate grading is essential for determining treatment strategy and follow-up frequency.

Treatment Options for Tricuspid Valve Disease

• Regular follow-up and monitoring for mild or asymptomatic disease
• Medications for symptom control
• Surgical or catheter-based intervention for severe cases

Medications for Managing Tricuspid Valve Disease

• Diuretics to reduce fluid overload
• Vasodilators (occasionally used to reduce right-sided pressures)
• Medications to manage heart rhythm
• Treatment of underlying conditions

Surgical Treatment Options

• Tricuspid valve repair
• Tricuspid valve replacement
• Combined valve surgery when needed

Tricuspid Valve Repair vs Replacement

Minimally Invasive & Transcatheter Treatments

Advances in interventional cardiology now allow selected patients to undergo minimally invasive or transcatheter tricuspid valve procedures. These options reduce surgical risk and recovery time, especially in high-risk individuals.

Tricuspid Valve Disease in Pregnancy

Pregnancy naturally increases blood volume and cardiac workload. Women with tricuspid valve disease require close monitoring, as symptoms may worsen during pregnancy, particularly in moderate to severe disease.

Tricuspid Valve Disease in Children

In children, tricuspid valve disease is often congenital. Early diagnosis and regular follow-up are essential to prevent long-term complications and ensure normal growth and development.

Complications of Untreated Tricuspid Valve Disease

Complications of untreated tricuspid valve disease include:

• Progressive right-sided heart failure
• Liver dysfunction
• Arrhythmias
• Reduced life expectancy

Lifestyle Changes & Self-Care

Lifestyle modifications that support heart health include:

• Low-salt diet
• Regular medical follow-up
• Managing underlying conditions
• Avoiding excessive alcohol and smoking

Prognosis & Life Expectancy

Prognosis depends on disease severity, underlying cause, and timely treatment. Early diagnosis and appropriate management significantly improve long-term outcomes and quality of life.

When to See a Cardiologist

Consult a cardiologist promptly if you experience:

• Persistent swelling or breathlessness
• New or worsening fatigue
• Known valve disease with symptom progression

Conclusion

Early diagnosis and timely management of tricuspid valve disease can help prevent right-sided heart strain and complications like fluid buildup and heart failure. If you notice symptoms such as swelling, breathlessness, fatigue, or palpitations, a structured cardiac evaluation can guide the right treatment plan and improve long-term outcomes.

Metropolis Healthcare supports proactive heart health with 4,000+ tests, full body checkups, and specialty testing for deeper clinical insights. With home sample collection across 10,000+ touchpoints, you get quick turnaround and accurate results, plus easy booking via website, call, app, or WhatsApp—making it simpler to test early and act sooner.

FAQs

What causes tricuspid valve disease?

It may result from rheumatic fever, congenital defects, infections, or conditions affecting the right side of the heart.

Is tricuspid valve disease serious?

Yes, especially if untreated, as it can lead to right-sided heart failure.

Can tricuspid valve disease be cured?

While it may not always be cured, symptoms can be effectively managed with appropriate treatment.

Does tricuspid valve disease require surgery?

Only moderate to severe cases typically require surgical or catheter-based intervention.

How is tricuspid valve disease diagnosed?

Diagnosis is mainly done through echocardiography, supported by other cardiac tests.

What is the life expectancy with tricuspid valve disease?

With early diagnosis and treatment, many individuals have a good long-term outlook.

Can tricuspid valve disease be treated without surgery?

Yes, mild cases are often managed with medications and regular monitoring.

Is tricuspid valve disease common?

It is less common than left-sided valve disorders but increasingly recognised.

Can lifestyle changes help tricuspid valve disease?

Lifestyle changes support treatment by reducing symptom burden and slowing disease progression.

References
1.    https://pmc.ncbi.nlm.nih.gov/articles/PMC5494422/ 
2.    https://www.uofmhealth.org/our-care/specialties-services/tricuspid-valve-disease
3.    https://www.sciencedirect.com/science/article/pii/S0033062008000844