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