murmur of tricuspid stenosis

I believe that many people do not know what tricuspid stenosis is, nor do they know how much impact this disease will have on our body, so everyone should learn more about relevant medical knowledge. The problem of tricuspid stenosis mainly refers to the increased dilation of the chest cavity, which will lead to insufficient lung capacity of the patient and cause symptoms such as difficulty breathing. It is necessary to adjust the tricuspid valve area through surgery.

1. Diastolic murmur in the tricuspid valve area The diastolic murmur of tricuspid stenosis is one of the important bases for the initial diagnosis. When auscultating, a weak, low-frequency and soft rumbling murmur can be heard in the middle and late diastolic periods between the 4th and 5th intercostal spaces on the left edge of the sternum and the midline of the sternum, and the pre-systolic enhancement is not obvious. In some patients, the murmur increases at the end of deep inspiration, which is called Carvallo sign. This is because the amount of venous blood returning to the right heart increases during inspiration, resulting in an increase in the blood flow rate and blood volume through the narrow tricuspid valve orifice. Key points for distinguishing mitral stenosis murmur: The murmur of mitral stenosis does not increase during inspiration, but increases at the end of deep exhalation.

2. The tricuspid valve opening sound can be heard in the tricuspid valve area: 0.04 to 0.06 seconds after S2, and it increases during inspiration.

3. S1 may be hyperactive in the tricuspid valve area: When the valve is obviously calcified or its mobility is significantly reduced, S1 may not be hyperactive. Murmur in the tricuspid valve area is the basis for the preliminary diagnosis of tricuspid stenosis. However, murmur is not a single basis. It should be combined with other physical signs such as typical jugular vein a wave and right atrial enlargement to make a preliminary diagnosis.

1. Typical signs - giant jugular venous a wave. Clinically, there is no right ventricular hypertrophy but a giant jugular venous a wave, which is a characteristic sign of tricuspid stenosis. This is because the right atrium contracts strongly against the narrow tricuspid valve during sinus rhythm, and the jugular vein shows a clear V wave during atrial fibrillation. If combined with right ventricular hypertrophy and severe pulmonary hypertension, the compliance of the right ventricle decreases, which increases the resistance to blood filling from the right atrium to the right ventricle, causing an increase in the jugular vein a wave.

2. Distension of the jugular veins: enlarged liver, positive hepatojugular reflux test, lower limb edema, and even peripheral cyanosis.

In short, diastolic murmur in the tricuspid valve area, typical jugular venous a wave and right atrial enlargement are important bases for the preliminary diagnosis of tricuspid stenosis. If a confirmed diagnosis is required, patients are recommended to undergo echocardiography and cardiac catheterization examination.