The diagnosis of tricuspid regurgitation is carried out according to:
- clinical examination: edema, ascites, an increase in the size of the liver, hepatojugular syndrome (pulsation of the liver). With auscultation, systolic murmur is determined along the left edge of the sternum, weakening of the basic tones;
- electrocardiogram (ECG): signs of hypertrophy of the right departments, often – atrial fibrillation, blockade of the right leg of the bundle of Giss;
- radiography of the chest cavity – expansion of the heart shadow due to the right departments;
Verification method is echocardiography (echocardiography), with the help of which the degree and stage of disturbances are established, pressure in the cavities, blood flow velocity and regurgitation volume are measured.
Echocardiography is used to safely diagnose fetal Ebstein anomaly in the third trimester of pregnancy.
Conservative and surgical methods of treatment are used to correct the patient’s condition.
Pharmacological support is aimed at eliminating signs of right ventricular failure:
- diuretics (diuretics) – Furosemide, Torsid for removing excess fluid from the body;
- antihypertensive drugs to reduce systemic pressure in the vessels;
- cardiac glycosides – Digoxin, Korglikon – to maintain the strength and frequency of myocardial contractions;
Surgical correction is prescribed to patients with moderate regurgitation and implies a complete replacement of the valve with a prosthesis (biological or mechanical) or plastic surgery of the right atrioventricular opening (narrowing of the lumen with sutures). Patients who underwent surgical correction of regurgitation are not suitable for military service.
If the above symptoms are found, the patient should visit a cardiologist. After the initial examination, the specialist can refer the patient to:
- chest and heart x-ray with esophagus contrast;
- ECG to detect an increase in heart muscle;
- sounding of the right departments of the heart organ;
- echocardiography with dopplerometry showing pressure in the heart muscle.
All of the above procedures will help the doctor make an accurate diagnosis, since it is very difficult to determine the tricuspid valve prolapse in the early stages without additional studies. Depending on the results of the examination, the doctor will prescribe the appropriate course of treatment.
If PTK does not cause significant discomfort to the patient, then its treatment is not required. However, with the manifestation of acute signs, it is necessary to immediately begin to eliminate them. Treatment is prescribed depending on the degree of pathology.
The therapeutic technique is intended for prolapse of the tricuspid valve of the first degree. It comes down to the normalization of the patient’s condition and constant monitoring of him, that is, observation by a cardiac surgeon. The patient is shown:
- Refuse bad habits like alcohol, which affect blood vessels.
- Eat a low fat diet.
- Perform minimal exercise to strengthen the heart muscle.
Medication, for the most part, is aimed at alleviating the symptoms of the disease, rather than treating it, as well as eliminating pulmonary hypertension. For this, the patient is prescribed:
- diuretic drugs;
- venous vasodilators;
- ACE inhibitors;
- beta blockers;
- cardiac glycosides;
- metabolic drugs;
Other drugs may be prescribed depending on the causes of PTC and concomitant diseases.
Surgical treatment is indicated for PTC of the third to fourth degree. To do this, apply:
- Tricuspid valve surgery:
- by boyd. A U-shaped seam is applied and tightened onto the fibrous ring, which narrows the valve opening.
- by De Vega. On the fibrous ring impose a semi-net seam.
- according to Carpentier. For narrowing, the support ring is hemmed.
- Tricuspid valve replacement. The valve is inspected, the valves are excised, after which the prosthesis is made of polymer material.
Prosthetics is usually resorted to if the patient is ill with infectious endocarditis, there is no plastic effect, or the valve is changed at a structural level. Prosthetics is a complex operation that can often be complicated.
Treatment with alternative medicine can be used only in conjunction with conservative and in the first stage of PTC. In other cases, it can interfere, because it will inhibit the symptoms, and the patient may miss a critical condition.
The following recipes are used to treat PTC:
- Herbal decoction. The flowers of hawthorn, heather and thorns are used in equal shares. Table. a collection spoon should be filled with a glass of hot boiled water, put in a water bath for 16 minutes. The resulting broth is decanted and drunk in two doses. Repeat the next day.
- Rosemary tincture. You need to take 100 grams of dried rosemary leaves and pour them 2 liters of dry red wine. Infuse the mixture for 2 months in a dark place, then take 50 ml three times a day.
- Peppermint decoction. China. 300 ml of hot boiled water is poured into a spoon of dry mint and an hour is infused. Then it is filtered and taken in half a glass three times a day.
Treatment may not be needed if the symptoms are absent or are mild. But if the symptoms manifest themselves quite openly and acutely, then treatment is a necessity. Depending on the stage of the disease, recovery methods will be different.
Diuretics and ACE inhibitors are used for 1 degree of tricuspid prolapse.
Preferably, the use of these drugs restores the structure of the valve and does not allow the development of the disease. In the later stages of prolapse (second or third), the use of medication will not be enough. Quite often, surgery is performed, which includes annuloplasty – reconstruction of the fibrous ring of the tricuspid valve. In exceptional cases, replacement is performed with prosthetics.
Prolapse of the heart valve is a disease characterized by a flattening of the valves in the atrium. Due to the loose fit of the valves, the pathology is accompanied by a change in the movement of blood: part of the blood changes direction, and from the ventricle enters the atrium.
This phenomenon is called regurgitation.
Pathologies of cardiac activity are noted with prolapse of the valves separating the atrium from the ventricle. The valves are open during diastole – this phenomenon corresponds to relaxation of the myocardium. When the heart contracts, which corresponds to systole, the valves are closed and obstruct the movement of blood from the ventricle back to the atrium.
Isolated prolapse of the tricuspid valve in younger children and adolescents is extremely rare, caused by the same reasons as the mitral valve defect.
With congenital minor prolapse, children are under the control of a cardiologist, but they are not prescribed treatment. The child is recommended swimming, physical education.
The decision to engage in professional sports is made by the doctor.
Therapy is aimed at improving myocardial nutrition, eliminating the dysfunction of the autonomic nervous system. To improve the contractility of the heart muscle, Riboxinum, Pananginum is prescribed.
If angina became the cause of the acquired defect, then the patient is prescribed antibiotics. Treatment is carried out in a hospital under the supervision of a doctor, alternative methods will not bring recovery, but only cause complications.
The patient’s condition improves with physiotherapeutic procedures:
- electrophoresis with bromine, magnesium;
- spinal massage;
The most successful operations, including minimally invasive ones, are done abroad.
Many parents choose, knowing about the powerful material and technical base and skillful hands of doctors in Israeli clinics.
The treatment of tricuspid valve prolapse in practice is realized by medication and surgery. The choice of treatment method depends on several factors: the individual characteristics of the patient’s body, the degree of development of the pathological process, the presence of complications from the heart, as well as concomitant diseases.
Drug treatment is carried out mainly with respect to prolapse of the tricuspid valve of the 1st degree. It is aimed at restoring valve structures and does not allow the pathological process to progress. In order to help such patients, doctors prescribe them medicines with a diuretic effect, as well as drugs from the groups of ACE inhibitors, cardiac glycosides, anticoagulants, beta-blockers.
More complex tricuspid prolapse variants require surgical correction. In the late stages of the disease, doctors offer their patients a planned surgical intervention with reconstruction (plastic surgery) of the fibrous ring of the valve or its prosthetics. The latter is preferred with the inefficiency of the performed plasty, endocarditis of infectious genesis, gross changes in the structure and structure of the valve apparatus.
The effectiveness of folk remedies in the treatment of tricuspid valve prolapse has not been proven. Prevention of the disease consists in quitting smoking and drinking alcoholic beverages, timely detection and treatment of underlying diseases, rational and balanced nutrition, moderate physical exertion. An unfavorable prognosis of the disease is considered to be the development of persistent tricuspid insufficiency. Patients with PTC die from increasing symptoms of heart failure, pneumonia, or pulmonary embolism.
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If the disease is at the first stage, then folk remedies can be used in addition to the main treatment.
For treatment, apply:
- herbal decoction of hawthorn, thorns and heather;
- rosemary tincture;
- decoctions of mint, hawthorn, motherwort, lemon balm, calendula, thyme, calendula, chamomile and oregano.
Complications and prognosis
The most common complications relate to the causes of the PTC. So, with insufficient treatment, the patient may develop secondary infectious endocarditis, rheumatism worsen. Also, PTC can lead to:
- Pulmonary embolism, i.e. blockage of the latter.
- Thrombosis of the prosthesis after surgical treatment.
- Atrioventricular block, characterized by circulatory disorders.
You need to understand that PTK itself leads to hemodynamic disturbances, which affects all organs, can lead to other complications.
Complications requiring surgical treatment include cases of rupture of the chord that attaches the cusp of the posterior valve to the wall of the ventricle, or the formation of adhesions restricting the movement of the cusps.
Complications of prolapse include the occurrence of valve insufficiency, in which a significant amount of blood is thrown into the atrium and causes weakness, shortness of breath.
With the progression of insufficiency, the patient undergoes valve replacement surgery.
Complications of valve prolapse include infectious endocarditis. The disease is accompanied by a rise in temperature, decreased pressure, discomfort, joint pain, yellowness of the skin.
Even grade 3-4 prolapse, with careful attention to health and systematic treatment, does not threaten life and does not lead to dangerous consequences.
Tricuspid valve prolapse (PTC) is a pathological condition of the heart caused by falling of the tricuspid valve cusps into the right atrium, which provokes the development of valvular insufficiency and is accompanied by a partial return of blood flow to the right atrium – regurgitation.
This ailment can hardly be called a common disease. He is rarely diagnosed: one case in several tens of thousands of people. Most often, the disease is detected in combination with, which, unlike the first, is diagnosed in every 5 inhabitants of our globe.
Pathological failure of the tricuspid valve is congenital and acquired. Most often, congenital abnormal defects of valve cusps and its fibrous ring arise as a result of intrauterine exposure to toxic factors on the fetus. This happens at about 3-9 weeks of pregnancy, when the body of the unborn baby is laying the vital organ structures.
Acquired tricuspid valve prolapse develops a second time, against the background of other pathological conditions:
- rheumatoid arthritis;
- drug addiction (less often alcoholism);
- carcinoid syndrome (the development of a carcinoid tumor provokes the appearance in the blood of a hormone that causes irreparable harm to valvular structures of the heart);
- infectious heart lesions (infectious endocarditis);
- damage to the chords and muscles of the tricuspid valve;
- chest injuries.
In a healthy heart, the valve closes completely; with prolapse, the TC does not close completely
Degrees and Forms
The tricuspid valve in the heart muscle opens when venous blood moves from the atrium to the subsequent section (ventricle) and blocks the reverse flow of fluid at closure. If the last action does not occur, this is called regurgitation.
Incomplete valve closure is called prolapse. It does not cause serious harm to a person in the early stages, but as it develops, it can cause significant discomfort to the patient.
The most common tricuspid valve prolapse occurs in men. This pathology in some cases is a complication of certain diseases. In children, prolapse is a birth defect. Women who have children in the womb, with PTC, often face additional complications, which leads to early childbirth.
There are 4 degrees of PTC:
At the first, a small regurgitation is characteristic, which does not seriously disrupt the functioning of the body.
The second degree is characterized by a reverse flow of blood into the ventricle, the distance of the stream does not exceed 20 mm.
In the third, significant regurgitation is distinguished for a gap of more than 20 mm.
With a significant outflow of blood back into the ventricle, doctors talk about the fourth degree of the disease.
Tricuspid regurgitation, developing against a background of vice, can be:
- primary, not accompanied by pulmonary hypertension and appearing against the background of the primary pathology of the heart muscle;
- secondary, appearing against the background of hypertrophy of the right ventricle and pulmonary hypertension;
First one. It is characterized by a reverse blood flow, which does not violate the general process of its movement through the vessels. There is a small prolapse of the tricuspid valve without significant regurgitation.
- The second one. With prolapse of the tricuspid valve of the 2nd degree, a reverse blood flow is observed at a distance of 20 mm from the tricuspid valve.
- The third. The distance increases by more than 20 mm.
- Fourth. Regurgitation is pronounced, takes place over a large extent from the cavity of the right atrium.
Tricuspid valve prolapse can be congenital, resulting from, or acquired, which develops in adulthood for a number of reasons.
The magnitude of the swelling of the valve in the atrium gives an idea of the severity of the pathology. With prolapse of the heart valve, the following are noted:
- At 1 degree – bulging of the valves up to 5 mm;
- At 2 degrees – the valves protrude into the atrium by 9 mm;
- With 3 degrees – the valves enter the atrium by 10 mm or more.
Quantitatively, regurgitation is determined by the length of the jet thrown into the atrium:
- O degree is detected by ultrasound in the form of protrusion of the valves in the direction of the atrium.
- 1 degree of regurgitation can be asymptomatic. At this stage, the length of the jet of reverse blood reflux does not exceed 1 cm.
- With 2 degrees of disease, it is observed with a stream length not exceeding 2 cm.
- For the 3rd degree of the disease, a jet length of more than 2 cm is characteristic.
- Grade 4 – the most severe, a stream of blood spreads over a large extent.
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