Presentation
Exercise intolerance, anorexia, pedal oedema.
Patient Data
Parasternal short axis: trace pericardial effusion, left ventricular function and wall thickness grossly normal. Interventricular septum flattened, with septal bowing toward left ventricle in both systole and diastole. Right ventricle dilated.
Apical 4 chamber: colour flow Doppler across tricuspid valve demonstrates aliasing, a large flow convergence zone, and a large tricuspid regurgitant jet into a dilated right atrium. Right ventricle is dilated with decreased function.
Case Discussion
Tricuspid regurgitation is not an uncommon finding, termed "functional" when no underlying pathology is present. Signs of right ventricular pressure and/or volume overload may increase suspicion of pathologic regurgitation, including flattening of the interventricular septum, right ventricular dilation, and right atrial dilation with leftward displacement of the interatrial septum 1.
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