Table Of Contents

Watch ▶Valvular heart disease: Pathology review

Tricuspid Regurgitation

Risk

• Functional (due to dilation of right atrium/ventricle).
• Valve damage from
  • Endocarditis with IVDU
  • Rheumatic fever
  • Injury from cardiac device
• Ebstein's anomaly.

Clinical

• Signs of right-sided congestive heart failure (JVD, RV heave, hepatomegaly, peripheral edema).
• Holosystolic murmur heard best at the left mid-sternal border.

Diagnosis

• Transthoracic echocardiography (TTE).

Management

• Functional regurgitation: Treat underlying disorder.
• Primary valve disease: Consider tricuspid valve repair or replacement.

Bicuspid Aortic Valve

Epidemiology

• Usually familial with autosomal dominant inheritance
• Affects approximately 1% of the population more common in males
• Strong association with Turner syndrome

Clinical Manifestations

• Accelerated valve calcification with early stenosis (age >40)
• Aortic regurgitation can develop (less common than stenosis)
• Increased incidence of ascending aortic aneurysm

Management

• Serial echo to monitor valve function and aneurysm development
• Echocardiographic screening of first-degree relatives

<aside> 💡

Congenital Bicuspid Aortic Valve is a common cause of both aortic stenosis and regurgitation in young patients

• AS usually presents in middle age ⇒ 40s - 50s (🆚 > 65 years in typical AS due to wear & tear) </aside>

Aortic Stenosis

Watch ▶Aortic stenosis: Clinical sciences

General

• Left ventricular outflow obstruction at the aortic valve.