Table 4.10 Summary: Echocardiographic features of tricuspid regurgitation


Aims of echocardiographic examination

Use 2DE to evaluate valvular structure:

gain subjective impression of volume overload

Use pulsed-wave Doppler to detect and map area of jet

Technique

Right parasternal long-axis view for overall assessment of cardiac function

Right parasternal long- and short-axis and oblique views for assessment of degree of volume overload and degree of VS flattening

Right parasternal long- and short-axis and oblique views to assess valve structure

Standard and tilted right parasternal long-, short- and oblique-axis views for pulsed-wave Doppler mapping

Common findings

No gross valvular abnormalities

No volume overload of right atrium or ventricle

Limited area of regurgitant flow detected on pulsed-wave Doppler mapping

Regurgitant jet positioned along right atrial wall where it borders the aorta

Other significant findings

Diffuse or localised valvular thickening

Valve prolapse

Flail leaflet

Arrhythmias

Other cardiac disease

Good prognostic indicators

No volume overload

No gross valvular abnormalities

Limited area of regurgitant flow detected on pulsed-wave Doppler mapping

Poor prognostic indicators

Marked volume overload

Flattening of the VS

Paradoxical septal motion

Substantial diffuse or localised valvular thickening

Flail leaflet

Vegetative lesions of endocarditis

Large area of jet of regurgitant blood detected on pulsed-wave Doppler mapping

Pathological arrhythmias