Tricuspid regurgitation is often reported as a secondary finding and rarely acted on, particularly in older patients with atrial fibrillation and preserved ejection fraction. When you read an echo report for a patient with heart failure, check the tricuspid regurgitation grade, the right ventricular size and function, and the estimated pulmonary pressure. Severe or worse regurgitation with right-sided congestion — raised JVP, oedema, hepatomegaly, rising diuretic doses — is now a reason to ask the heart team whether transcatheter repair is an option, not just to increase the loop diuretic.
- Check the tricuspid regurgitation grade on every heart failure echo report.
- Note right ventricular size and function and the estimated pulmonary artery pressure.
- Rising diuretic needs with raised JVP and hepatomegaly suggest significant tricuspid regurgitation.
- Refer severe tricuspid regurgitation to the heart team rather than escalating diuretics alone.
Why it matters
A finding that used to be noted and ignored now has a treatment that changes outcomes.
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