Tricuspid regurgitation: on CTPA

Case contributed by Dr Chris O'Donnell

Presentation

Patient presents with severe tricuspid regurgitation/incompetence on echocardigraphy. CTPA to assess for pulmonary embolism

Patient Data

Age: 60
Gender: Female

IV contrast injection form the right arm has enetered a dilated right atrium and then refluxed into the IVC and dilated heptic veins (arrows) as well as the dilated coronary sinus (arrow).  No pulmonary embolism.

Case Discussion

Incompetence at the tricuspid valve has allowed (contrast) opacified blood, that has passed from the right atrium into the right ventricle, to reflux back into the IVC and hepatic veins as well as the coronary sinus i.e. venous structures that communicate with the right atrium that should only contain unopacified blood.  This is the radiological (CT) equivalent of the clinical pulsatile liver seen in tricuspid regurgitation.

PlayAdd to Share

Case information

rID: 42351
Case created: 17th Jan 2016
Last edited: 18th Jan 2016
System: Cardiac
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.