Right Atrioventricular Valve (Tricuspid Valve)

Introduction

The heart is composed of four chambers: two atria and two ventricles. Blood flows through these chambers with the help of valves, which prevent backflow and ensure unidirectional circulation. The right atrioventricular valve, commonly known as the tricuspid valve, plays a crucial role in this process.

Anatomy of the Tricuspid Valve

The tricuspid valve is located between the right atrium and the right ventricle. It consists of three leaflets (cusps) attached to the heart's fibrous skeleton and is supported by chordae tendineae connected to the papillary muscles.

Function

The tricuspid valve allows deoxygenated blood to flow from the right atrium into the right ventricle. During ventricular contraction (systole), the valve closes to prevent blood from regurgitating into the right atrium, ensuring forward circulation toward the lungs for oxygenation.

Common Diseases and Conditions

Several conditions may affect the tricuspid valve:

1. Tricuspid Regurgitation: The valve fails to close properly, allowing blood to flow back into the right atrium. Causes include:

   • Right ventricular dilation (due to heart failure, pulmonary hypertension, or other conditions)
   • Infective endocarditis
   • Rheumatic heart disease
   • Congenital defects

2. Tricuspid Stenosis: Narrowing of the valve opening, reducing blood flow to the right ventricle. Causes include:

   • Rheumatic heart disease
   • Congenital malformations
   • Carcinoid syndrome

3. Tricuspid Valve Prolapse: The valve leaflets bulge into the right atrium, sometimes causing regurgitation.

Symptoms of Tricuspid Valve Disorders

Depending on the severity, symptoms may include: - Fatigue - Swelling of the abdomen and legs (edema) - Shortness of breath - Palpitations - Jugular vein distention

Diagnostic Methods

Doctors use a combination of tests to diagnose tricuspid valve disorders: - Echocardiography (ultrasound of the heart) – the primary imaging modality. - Electrocardiogram (ECG) – to assess arrhythmias. - Chest X-ray – to evaluate heart size. - Cardiac MRI – detailed imaging for structural abnormalities. - Right heart catheterization – measuring pressure inside the heart.

Treatment Options

Treatment depends on the underlying cause and severity of the condition:

• Medications: Diuretics, beta-blockers, and vasodilators may help manage symptoms but do not cure structural problems.
• Surgical Repair or Replacement:
  • Valve repair (such as annuloplasty) is often preferred over replacement.
  • Valve replacement may involve mechanical or bioprosthetic valves.
• Catheter-Based Interventions: New, minimally invasive techniques are emerging as alternatives for high-risk patients.

Conclusion

The right atrioventricular (tricuspid) valve is essential for proper heart function. Early detection of valve disorders and appropriate treatment can improve quality of life and prevent complications. If you experience any symptoms of heart valve disease, consult your healthcare provider for evaluation.

Source recommendations

1. American College of Cardiology/American Heart Association Guidelines for the Management of Valvular Heart Disease

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923
2. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/12/16/21/58/2020-ACC-AHA-VHD-GL-Pt-1-GL-VHD
3. https://pubmed.ncbi.nlm.nih.gov/33332149/
4. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/03/13/18/13/2024-acc-aha-clinical-performance-valvular
5. https://pubmed.ncbi.nlm.nih.gov/9809971/

2. European Society of Cardiology Guidelines for the Management of Valvular Heart Disease

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Valvular-Heart-Disease-Guidelines
2. https://academic.oup.com/eurheartj/article/43/7/561/6358470
3. https://pubmed.ncbi.nlm.nih.gov/34453165/
4. https://eurointervention.pcronline.com/article/2021-esc-eacts-guidelines-for-the-management-of-valvular-heart-disease
5. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923