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Secrets of the Right Atrium: How Tricuspid Regurgitation Causes Heart Failure?
With the aging of the population and the increasing incidence of heart disease, tricuspid regurgitation, a cardiac pathological condition, has gradually attracted attention from the medical community. Tricuspid regurgitation (TR) is a heart valve disease in which the tricuspid valve, located between the right atrium and right ventricle, fails to close completely during ventricular contraction, allowing blood to flow into the right side in the opposite direction. atrium, which may lead to right heart failure and other complications.
Tricuspid regurgitation increases the blood volume and pressure in the right atrium and right ventricle. If the regurgitation is severe enough, it may also affect the volume and pressure of the central veins.
Causes of tricuspid regurgitation
The causes of tricuspid regurgitation can be divided into congenital and acquired factors, among which acquired factors are more common. Common acquired tricuspid regurgitation is often due to right ventricular dilatation, which is usually associated with left heart failure or pulmonary hypertension. Other possible causes include right ventricular infarction, inferior wall myocardial infarction, and cor pulmonale.
The mechanism of tricuspid valve insufficiency is often related to the expansion of the tricuspid valve annulus. This expansion often leads to geometric changes in the position of the valve leaflets, affecting its normal function.
Symptoms of tricuspid regurgitation
Symptoms of tricuspid regurgitation vary with the severity of the condition. Mild tricuspid regurgitation may not cause obvious symptoms, but as the condition worsens, patients may develop symptoms of right heart failure, such as ascites, peripheral edema, etc. When severe right heart failure occurs, venous congestion may lead to the development of cardiorenal syndrome and liver failure.
During clinical examination, the doctor may hear a holosystolic murmur, which is often a clear indicator of disease.
Diagnosis process
Diagnosis of tricuspid regurgitation usually requires the discovery of typical murmurs through auscultation, and further diagnosis relies on echocardiography. This technique is able to measure the presence and severity of reflux and assess right ventricular size and systolic blood pressure.
In imaging examination, when the reflux volume is greater than 45 ml or the rate of reflux from the tricuspid valve exceeds 50%, it is associated with a poor prognosis.
Management and Treatment
Drug treatment
Medical treatment of tricuspid regurgitation usually includes diuretics because edema and fluid accumulation often accompany symptoms of right heart failure. After the disease progresses, the effect of diuretics may decrease, leading to the phenomenon of "diuretic resistance". This is caused by a series of physiological changes caused by insufficient blood perfusion in the kidneys.
Surgical treatment
Surgical treatment may be considered in patients with organic lesions or severe functional reflux. For example, when the heart undergoes open-heart surgery, repairing the tricuspid valve is also a concern. Surgical approaches may include annular shaping or tricuspid valve replacement.
According to the majority of the literature, patients who undergo correctly indexed tricuspid valve surgery have significantly improved survival outcomes.
Prognosis
The prognosis of tricuspid regurgitation is less ideal than that of other valve diseases, especially in female patients where the disease progresses faster. Studies have shown that even mild tricuspid regurgitation has an impact on survival, with patients having a significantly increased risk of death compared with healthy individuals.
Conclusion
Tricuspid regurgitation is a heart health problem that cannot be ignored and may lead to serious complications as the condition progresses. How to timely identify and effectively manage this disease will become one of the challenges facing the medical community. Do you know how healthy your heart is?
