Tricuspid Valve Disease
   HOME

TheInfoList



OR:

The tricuspid valve, or right atrioventricular valve, is on the right dorsal side of the mammalian
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
, at the superior portion of the
right ventricle A ventricle is one of two large chambers toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper ...
. The function of the valve is to allow
blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...
to flow from the
right atrium The atrium ( la, ātrium, , entry hall) is one of two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular valves. There are two atr ...
to the right ventricle during
diastole Diastole ( ) is the relaxed phase of the cardiac cycle when the chambers of the heart are re-filling with blood. The contrasting phase is systole when the heart chambers are contracting. Atrial diastole is the relaxing of the atria, and ventric ...
, and to close to prevent backflow ( regurgitation) from the right ventricle into the
right atrium The atrium ( la, ātrium, , entry hall) is one of two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular valves. There are two atr ...
during right ventricular contraction (
systole Systole ( ) is the part of the cardiac cycle during which some chambers of the heart contract after refilling with blood. The term originates, via New Latin, from Ancient Greek (''sustolē''), from (''sustéllein'' 'to contract'; from ''sun ...
).


Structure

The tricuspid valve usually has three cusps or leaflets, named the anterior, posterior, and septal cusps. Each leaflet is connected via
chordae tendineae The chordae tendineae (tendinous cords), colloquially known as the heart strings, are inelastic cords of fibrous connective tissue that connect the papillary muscles to the tricuspid valve and the mitral valve in the heart. Structure The chordae ...
to the anterior, posterior, and septal
papillary muscle The papillary muscles are muscles located in the ventricles of the heart. They attach to the cusps of the atrioventricular valves (also known as the mitral and tricuspid valves) via the chordae tendineae and contract to prevent inversion or prol ...
s of the
right ventricle A ventricle is one of two large chambers toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper ...
, respectively. Tricuspid valves may also occur with two or four leaflets; the number may change over a lifetime.


Function

The tricuspid valve functions as a one-way valve that closes during
ventricular systole The cardiac cycle is the performance of the human heart from the beginning of one heartbeat to the beginning of the next. It consists of two periods: one during which the heart muscle relaxes and refills with blood, called diastole, following ...
to prevent regurgitation of blood from the right ventricle back into the right atrium. It opens during ventricular diastole, allowing blood to flow from the right atrium into the right ventricle. The back flow of blood is also known as regression or
tricuspid regurgitation Tricuspid regurgitation (TR), also called tricuspid insufficiency, is a type of valvular heart disease in which the tricuspid valve of the heart, located between the right atrium and right ventricle, does not close completely when the right ventri ...
. Tricuspid regurgitation can result in increased ventricular preload because the blood refluxed back into the atrium is added to the volume of blood that must be pumped back into the ventricle during the next cycle of ventricular
diastole Diastole ( ) is the relaxed phase of the cardiac cycle when the chambers of the heart are re-filling with blood. The contrasting phase is systole when the heart chambers are contracting. Atrial diastole is the relaxing of the atria, and ventric ...
. Increased right ventricular preload over a prolonged period of time may lead to right
ventricular enlargement Cardiomegaly (sometimes megacardia or megalocardia) is a medical condition in which the heart is enlarged. As such, it is more commonly referred to simply as "having an enlarged heart". It is usually the result of underlying conditions that make t ...
(dilatation), which can progress to right heart failure if left uncorrected.


Clinical significance

Infected valves can result in
endocarditis Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves. Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or the ...
in
intravenous drug Drug injection is a method of introducing a drug into the bloodstream via a hollow hypodermic needle, which is pierced through the skin into the body (usually intravenously, but also at an intramuscular or Subcutaneous injection, subcutaneous l ...
users. Patients who inject narcotics or other drugs intravenously may introduce infection, which can travel to the right side of the heart, most often caused by the
bacteria Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were among ...
'' S. aureus''. In patients without a history of intravenous exposure, endocarditis is more frequently left-sided. The tricuspid valve can be affected by
rheumatic fever Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a streptococcal throat infection. Signs and symptoms include fever, multiple painful jo ...
, which can cause
tricuspid stenosis Tricuspid valve stenosis is a valvular heart disease that narrows the opening of the heart's tricuspid valve. It is a relatively rare condition that causes stenosis (increased restriction of blood flow through the valve). Cause Causes of tricuspi ...
or tricuspid regurgitation. Some individuals are born with
congenital A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...
abnormalities of the tricuspid valve. Congenital apical displacement of the tricuspid valve is called
Ebstein's anomaly Ebstein's anomaly is a congenital heart defect in which the septal and posterior leaflets of the tricuspid valve are displaced towards the apex of the right ventricle of the heart. It is classified as a critical congenital heart defect accounting ...
and typically causes significant
tricuspid regurgitation Tricuspid regurgitation (TR), also called tricuspid insufficiency, is a type of valvular heart disease in which the tricuspid valve of the heart, located between the right atrium and right ventricle, does not close completely when the right ventri ...
. Certain carcinoid syndromes can affect the tricuspid valve by producing fibrosis due to
serotonin Serotonin () or 5-hydroxytryptamine (5-HT) is a monoamine neurotransmitter. Its biological function is complex and multifaceted, modulating mood, cognition, reward, learning, memory, and numerous physiological processes such as vomiting and vas ...
production by those tumors. The first endovascular tricuspid valve implant was performed by surgeons at the
Cleveland Clinic Cleveland Clinic is a nonprofit American academic medical center based in Cleveland, Ohio. Owned and operated by the Cleveland Clinic Foundation, an Ohio nonprofit corporation established in 1921, it runs a 170-acre (69 ha) campus in Cleveland, ...
.


Tricuspid regurgitation

Tricuspid regurgitation Tricuspid regurgitation (TR), also called tricuspid insufficiency, is a type of valvular heart disease in which the tricuspid valve of the heart, located between the right atrium and right ventricle, does not close completely when the right ventri ...
is common and is estimated to occur in 65–85% of the population. In the
Framingham Heart Study The Framingham Heart Study is a long-term, ongoing cardiovascular cohort study of residents of the city of Framingham, Massachusetts. The study began in 1948 with 5,209 adult subjects from Framingham, and is now on its third generation of participa ...
presence of any severity of tricuspid regurgitation, ranging from trace to above moderate was in 82% of men and in 85.7% of women. Mild tricuspid regurgitation tends to be common, benign, and in structurally normal tricuspid valve apparatus can be considered a normal
variant Variant may refer to: In arts and entertainment * ''Variant'' (magazine), a former British cultural magazine * Variant cover, an issue of comic books with varying cover art * ''Variant'' (novel), a novel by Robison Wells * " The Variant", 2021 e ...
. Moderate or severe
tricuspid regurgitation Tricuspid regurgitation (TR), also called tricuspid insufficiency, is a type of valvular heart disease in which the tricuspid valve of the heart, located between the right atrium and right ventricle, does not close completely when the right ventri ...
is usually associated with tricuspid valve leaflet abnormalities and/or possibly annular dilation and is usually pathologic which can lead to irreversible damage of
cardiac muscle Cardiac muscle (also called heart muscle, myocardium, cardiomyocytes and cardiac myocytes) is one of three types of vertebrate muscle tissues, with the other two being skeletal muscle and smooth muscle. It is an involuntary, striated muscle th ...
and worse outcomes due to chronic prolonged
right ventricular volume overload Volume overload refers to the state of one of the chambers of the heart in which too large a volume of blood exists within it for it to function efficiently. Ventricular volume overload is approximately equivalent to an excessively high preload. ...
.


Additional images

File:Slide14bek.JPG, Tricuspid valve. Deep dissection. File:Tricuspid valve * Válvula tricúspide.svg, Tricuspid valve marked in yellow. File:MitralInsufficiency.jpg, Diagram of tricuspid insufficiency/regurgitation. Marked in black arrow.


See also

*
Tricuspid atresia Tricuspid atresia is a form of congenital heart disease whereby there is a complete absence of the tricuspid valve. Therefore, there is an absence of right atrioventricular connection. This leads to a hypoplastic (undersized) or absent right ventri ...
*
Cavo-tricuspid isthmus The cavo-tricuspid isthmus is a body of fibrous tissue in the lower right atrium between the inferior vena cava, and the tricuspid valve. It is a target for ablation for treating atrial flutter Atrial flutter (AFL) is a common abnormal heart rhy ...
*
Lancisi's sign Lancisi's sign is a medical sign, clinical sign in which a large venous wave, or ''Giant V wave'', is visible in the jugular vein in patients with tricuspid regurgitation. It is caused by blood flowing backwards into the jugular vein through the inc ...
*
Right atrial enlargement Rights are legal, social, or ethical principles of freedom or entitlement; that is, rights are the fundamental normative rules about what is allowed of people or owed to people according to some legal system, social convention, or ethical theory ...


References


External links

* * Photo of model
circulation/tricuspidvalve04
at
Waynesburg College Waynesburg University is a private university in Waynesburg, Pennsylvania. It was established in 1850 and offers undergraduate and graduate programs in more than 70 academic concentrations. The university enrolls over 2,500 students, including ...

Cardiac Valve Animations - Perioperative Interactive Education Group
{{DEFAULTSORT:Tricuspid Valve Cardiac anatomy Heart valves