DEAR DR. GOTT: I would like to know more about tricuspid regurgitation. I’ve been exercising for more than 25 years and just learned I have this condition. It has been called mild. I see my specialist later this month but don’t know how to exercise with the diagnosis.
DEAR READER: Tricuspid regurgitation, also known as insufficiency, occurs when this particular valve in the heart fails to close properly. This causes blood to flow backward into the right atrium (upper-heart chamber) when the right ventricle (lower-heart chamber) contracts.
There are several reasons this may occur, including but not limited to injury to the right ventricle, radiation therapy, carcinoid tumors, rheumatoid arthritis, rheumatic fever, Marfan syndrome and, in the presence of Ebstein’s anomaly, a congenital heart disorder.
Without pulmonary hypertension, there may be no symptoms at all. When pulmonary hypertension and moderate to severe tricuspid regurgitation occur together, patients may experience fatigue, pulsing of the neck veins, decreased urinary output, weakness, symptoms of right-sided heart failure and edema of the feet, ankles and stomach.
A physician can make a diagnosis if he or she feels a pulse over the liver or swelling of the liver and spleen, when a murmur or abnormal sounds are heard through a stethoscope. A physician may choose to order a chest X-ray, EKG or echocardiogram to correctly diagnose the disorder. Laboratory testing may reflect abnormal liver function and hyperbilirubinemia (jaundice). Some medications may cause symptoms and include those for Parkinson’s disease, migraine headaches and obesity.
Mild cases may not require any treatment at all. More advanced cases may require brief hospitalization to verify the diagnosis and bring symptoms under control. Any underlying conditions would be addressed during the hospitalization. Should surgery be required, it may include repair or replacement of the valve.
Patients should reduce their salt intake and may find relief by elevating the head of their beds to combat feelings of shortness of breath. If you haven’t already, I recommend you engage the services of a cardiologist and rely on his or her judgment when it comes to how much exercise you should undertake. I am unaware of any other medical conditions you might have and cannot make that decision.
To provide related information, I am sending you a copy of my Health Report “Coronary Artery Disease.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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