Minor mitral regurgitation

Under normal circumstances, our body's mechanisms work in the order they should be installed. Once affected by some factors, some abnormal phenomena will occur, which will lead to some health problems. Reflux is an abnormal condition. When a small amount of mitral and tricuspid valve reflux occurs, if it does not affect your life and work, you should pay attention to rest and avoid physical labor, and the symptoms will gradually ease.

Manifestations of minor mitral and tricuspid regurgitation

The signs and symptoms of tricuspid regurgitation are related to the degree of tricuspid regurgitation. Mild regurgitation is not easily detected clinically. More serious cases may cause fatigue, poor appetite, bloating and pain in the liver area, abdominal distension, and lower limb edema.

Characteristics of minor mitral and tricuspid regurgitation

Distended jugular veins with pulsation;

Hepatomegaly with palpable pulsations and a holosystolic blowing murmur at the fourth intercostal space on the left side of the sternum that increases with late inspiration (Carvallo sign). Classic signs may be absent in patients with severe tricuspid regurgitation. If the liver is sclerotic due to long-term congestion, it will no longer pulsate; when the right heart volume load reaches its limit, the murmur will no longer increase with inspiration, so the Carvallo sign can be negative.

The radiograph showed right atrial and ventricular hypertrophy with bulging of the right edge of the heart, as well as changes caused by other valvular diseases. The electrocardiogram shows atrial hypertrophy, tall and wide P waves; there is also right bundle branch block or right ventricular hypertrophy, and even myocardial strain. Atrial fibrillation is common.

Echocardiography and Doppler examination:

Sectional ultrasound can detect the size of the tricuspid valve annulus and understand the thickening of the valve, which is helpful to distinguish between relative and organic lesions. When the tricuspid valve is regurgitant, ultrasound angiography can show microbubbles moving back and forth between the tricuspid valve; Doppler can directly monitor abnormal signals from the right ventricle to the right atrium and estimate the degree of reflux.

Cardiac catheter examination showed a prominent V wave of the right atrial pressure waveform and a steepening of the Y descending branch, which was more obvious during inspiration. The right atrial pressure waveform is similar to the right ventricular pressure waveform, but with a smaller amplitude. This is called right ventricularized right atrial pressure and is a manifestation of severe tricuspid regurgitation.

Cardiovascular angiography:

Right ventriculography and right anterior oblique cine can demonstrate tricuspid regurgitation and its extent. However, since the cardiac catheter crosses the tricuspid valve, there is a potential for false positives.

The diagnosis of tricuspid regurgitation should include an understanding of the degree of regurgitation. Typical clinical signs are of certain value in diagnosing severe tricuspid regurgitation. In the past, right ventriculography was used as a means to diagnose suspicious cases and estimate the extent of regurgitation. In recent years, ultrasound and Doppler examinations have gradually replaced invasive examinations.