Rheumatic tricuspid stenosis without involvement of the mitral valve

Mittal, S.R.; Upadhyay, Satyam; Saxena, Renu

doi:10.1016/0167-5273(89)90050-8

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…[10][11][12][13] There is major difference in prevalence among patients diagnosed non-invasively and at autopsy (7.7% versus 38.5%) Non-invasive study by Goswami et [14][15][16][17][18][19][20] probably the patients in autopsy studies died from RHD, and were likely to have the severest form of the disease, with significant involvement of the tricuspid valve. However Right sided valves receive less attention and its presence overlooked during routine echocardiography evaluation 21 Mitral valve disease was the most frequently associated lesion. 22 Today, echocardiography remains the most commonly used, accurate and non-invasive tool for the diagnosis of tricuspid valve disease.…”

Section: Discussionmentioning

confidence: 99%

Organic Tricuspid Valve Disease in Chronic Rheumatic Heart Disease: A Prospective Echocardiography Study

Sharma¹,

Padhy²,

Mohanty³

et al. 2019

jebmh

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BACKGROUND Tricuspid valve disease (TV) in chronic rheumatic heart disease is relatively less prevalent, is almost always of rheumatic in origin, and generally accompanies mitral valve disease. Majority of studies on prevalence of tricuspid valve involvement are mainly based on tertiary care hospital, pathological or autopsy study and hence may not reflect the true prevalence because of inherent bias of more symptomatic and severe disease. Asymptomatic and less severe form of chronic RHD are not represented. In rheumatic TV involvement, the cusps are thickened, and commissures are fused, there is narrowing of valve area, can be evaluated by Echocardiography even in clinically silent RHD. Echocardiography can result in detection of higher prevalence of disease. We wanted to determine the prevalence of tricuspid valve involvement in patients with chronic RHD by echocardiography study in a tertiary care hospital and peripheral centers to include symptomatic as well as asymptomatic chronic RHD. METHODS This long-term prospective study was conducted at VSSIMSAR, Burla and recognized diagnostic centre in nearby district headquarter to include and cover representative population of this part of our country including people coming for different routine cardiac evaluations from October 2016 to November 2018. Around 679 patients in the age group of less than 10 yrs. to more than 70 years were evaluated by echocardiography study. RESULTS Out of 679 patients of RHD 458 (67%) were female and 221 (33%) were male. 36 patients (5.1%) had organic TV involvement. Tricuspid valve involvement was always combined with either mitral valve in 2.6% of cases and both mitral and aortic valves in 2.5% of cases in varying combinations. The most common lesion associated with organic TV disease was Severe MS Mild MR Mild AR followed by Severe MS Mild MR, Mild MR Mod AR, Mod MS Severe MR Mild AR and Mild MR. No isolated organic tricuspid valve disease was observed. 24% of cases had evidence of hypertensive TR along with other significant valvular lesions and around 32% had Mild to Moderate functional TR. Associated organic pulmonary valve disease was detected in 0.14% of cases.

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Section: Discussionmentioning

confidence: 99%

Organic Tricuspid Valve Disease in Chronic Rheumatic Heart Disease: A Prospective Echocardiography Study

Sharma¹,

Padhy²,

Mohanty³

et al. 2019

jebmh

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A case report of isolated rheumatic tricuspid regurgitation and pericarditis

Alhadramy

2021

Journal of Taibah University Medical Sciences

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Rheumatic fever (RF) is a complex syndrome in which the human body develops antibodies against β-haemolytic streptococcus, and triggers inflammation in various organs. RF valvulitis mostly affects the mitral valve (MV) and, to a lesser extent, the aortic valve (AV). Isolated rheumatic tricuspid valve (TV) disease and pericarditis is extremely rare and is not well described in the RF guidelines. The current case demonstrates the echocardiographic findings of TV valvulitis of RF and describes the presentation and electrocardiogram (ECG) changes in pericarditis. We present the case of a 16-year-old male patient who developed upper respiratory tract infection followed by typical pericarditis chest pain. The patient had no history of joint pain or swelling, but was found to have a tricuspid regurgitation (TR) murmur upon examination. Laboratory investigations revealed an elevated erythrocyte sedimentation rate, and elevated C-reactive protein and antistreptolysin O titres. ECG showed a wide-spread 1.5 mm upward concave ST-segment elevation. In echocardiography, the TV opened well with markedly thickened leaflets and severe TR, while the MV and AV were normal in both structure and function. The diagnosis of RF was established and treatment with high-dose aspirin and antibiotics was initiated. The treatment led to resolution of the chest pain. Our case highlights that the physical and lab findings of rheumatic TR are similar to those of rheumatic mitral regurgitation, with the exception of a high-velocity jet. Similarly, the presentations of rheumatic pericarditis are similar to other types and may also respond to high-dose aspirin. Finally, physicians should be familiar with both the common and rare complications of RF because the guidelines have placed Middle East region among the high-risk countries.

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Isolated Rheumatic Tricuspid Stenosis with Reverse Lutembacher's Physiology

1999

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Tricuspid valve dysfunction occurs frequently in patients with rheumatic heart disease and is usually manifested as functional or organic tricuspid regurgitation. Rheumatic tricuspid stenosis is less common and occurs characteristically in the presence of concomitant mitral valve disease. In this report, we describe the clinical and echocardiographic findings in a patient with isolated rheumatic tricuspid stenosis and a right-to-left shunt across the interatrial septum, likely as a result of a patent foramen ovale, resulting in central cyanosis. This case illustrates an interesting association of tricuspid stenosis and an interatrial right-to-left shunt suggestive of a reverse Lutembacher's physiology.

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Rheumatic tricuspid stenosis without involvement of the mitral valve

Cited by 3 publications

References 5 publications

Organic Tricuspid Valve Disease in Chronic Rheumatic Heart Disease: A Prospective Echocardiography Study

Organic Tricuspid Valve Disease in Chronic Rheumatic Heart Disease: A Prospective Echocardiography Study

A case report of isolated rheumatic tricuspid regurgitation and pericarditis

Isolated Rheumatic Tricuspid Stenosis with Reverse Lutembacher's Physiology

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