The Trikuspidalklappenstenose (TS) describes the narrowing of the Trikuspidalklappenöffnung that impedes the flow of blood from the RA into the RV. Nearly all cases are caused by rheumatic fever. Symptoms include a fluttering discomfort in the throat, fatigue, cold skin and abdominal discomfort in the right upper quadrant. Jugularvenenpulsationen are striking and it is often a presystolic murmur at the left sternal part in the 4th ICR; it increases during inhalation. The diagnosis is made by echocardiography. The TS is usually benign, does not require any specific treatment, but some patients benefit from surgical treatment.

The Trikuspidalklappenstenose (TS) describes the narrowing of the Trikuspidalklappenöffnung that impedes the flow of blood from the RA into the RV. Nearly all cases are caused by rheumatic fever. Symptoms include a fluttering discomfort in the throat, fatigue, cold skin and abdominal discomfort in the right upper quadrant. Jugularvenenpulsationen are striking and it is often a presystolic murmur at the left sternal part in the 4th ICR; it increases during inhalation. The diagnosis is made by echocardiography. The TS is usually benign, does not require any specific treatment, but some patients benefit from surgical treatment.

(See also Overview of the heart valve diseases.) The Trikuspidalklappenstenose (TS) describes the narrowing of Trikuspidalklappenöffnung which obstructs blood flow from the RA into the RV. Nearly all cases are caused by rheumatic fever. Symptoms include a fluttering discomfort in the throat, fatigue, cold skin and abdominal discomfort in the right upper quadrant. Jugularvenenpulsationen are striking and it is often a presystolic murmur at the left sternal part in the 4th ICR; it increases during inhalation. The diagnosis is made by echocardiography. The TS is usually benign, does not require any specific treatment, but some patients benefit from surgical treatment. The tricuspid stenosis is almost always the result of rheumatic fever; it is almost always a TIvorhanden, just like a rheumatic Mitralklappenvalvulopathie (usually mitral). Among the rare causes of tricuspid stenosis include SLE, Myoxome of the right atrium, congenital malformations, and metastatic tumors. The RA is hypertrophied and extended, and develop the consequences induced by the right heart disease heart failure, but without RV dysfunction; RV remains under crowded and small. Rarely occurs atrial fibrillation. Symptoms and complaints The only sign of severe tricuspid stenosis are a fluttering discomfort in the throat (due to huge a-waves in Jugularvenenpuls), fatigue and cold skin (due to low cardiac output) and abdominal discomfort in the right upper quadrant (due to an enlarged liver) , The primary visible sign is the vast fluttering a wave with a gradual drop in the y-jugular veins. An extension of the jugular veins can occur, which increases with the inhalation (Kussmaul-characters). The face may be dark and the head veins may dilate when the patient is lying down (blush character). There may be an overload of Leberhepatische congestion and peripheral edema. Auscultation auscultation the tricuspid stenosis can not be heard often, but may cause a slight Öffnungton and a rumble in the middle of diastole with präsystolischer accentuation. The noise is louder and longer with maneuvers that increase venous return (lifting load, inspiration, legs, Mueller maneuver), and softer and shorter during maneuvers that reduce venous return (standing, Valsalva maneuver). The findings of the tricuspid stenosis often occur simultaneously with those of a mitral valve stenosis, they are less prominent. The sounds can be clinically distinguished (see table: distinguishing the sounds of Trikuspidalklappenstenose and mitral valve stenosis). Distinguishing the sounds of Trikuspidalklappenstenose and mitral feature Trikuspidalklappenstenose mitral nature Scratching rumble duration Short Long temporal occurrence Starts in early diastole and rises to S1 not to increases in the course of diastole Enhancing Factor inspiration Exercise localization Lower right and left Sternumgrenzen apex when the patient lies on the left side in decubitus position S1 = 1 heart sound. Diagnostic echocardiography The diagnosis is suspected based on history and physical examination and confirmed by Doppler echocardiography showing a pressure gradient across the tricuspid valve. As severe tricuspid stenosis, a TS is denoted by an average gradient over the flap of> 5 mmHg. The two-dimensional echocardiography shows thickened leaflets with reduced mobility and a RA and magnification. The ECG may show a RA-magnification disproportionate for RV hypertrophy and high, spitzgipfelige P-waves in the inferior leads and V1. The X-ray chest film may have a dilated superior vena cava and a RA-magnification which is indicated by an enlarged right heart border. The liver enzymes are increased due to hepatic congestion. A cardiac catheterization is rarely indicated for the diagnosis of tricuspid stenosis. If it is indicated (eg. As the coronary anatomy to investigate), the findings include an increased pressure in the RA with a slow decrease in early diastole, and a pressure gradient across the tricuspid valve. Treatment diuretics and aldosterone antagonists Rarely valve repair or valve replacement, the evidence for a treatment recommendation in tricuspid stenosis is sparse. Symptomatic patients who do not undergo any intervention should receive reduced salt diet, diuretics and aldosterone antagonists. Patients with severe tricuspid stenosis should be subjected to an intervention if they show symptoms or if heart surgery is performed with them for other reasons. Percutaneous Ballontrikuspidalkommissurotomie may be considered in severe tricuspid stenosis without accompanying TI. Summary tricuspid stenosis almost always arises because of rheumatic fever; it is often the same tricuspid regurgitation and mitral stenosis present. The heart sounds include a soft opening signal and a rumble in the middle of the diastole with präsystolischer accentuation. The noise becomes louder in maneuvers and longer, increasing venous return (z. B. exposure, inhalation, legs lift), and softer and shorter during maneuvers that reduce venous return (standing, Valsalva maneuver). The treatment includes diuretics and aldosterone antagonists, a surgical valve repair or valve replacement are rarely necessary.

Health Life Media Team

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