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Mitral regurgitation, also known as mitral insufficiency or mitral incompetence, is the backward flow of blood from the left ventricle, through the mitral valve, and into the left atrium, when the left ventricle contracts, resulting in a systolic murmur radiating to the left armpit. [5] [3]
During open heart surgery for another issue (e.g. mitral valve), fixing the tricuspid valve may be considered, but medical consensus is unclear. Some argue that even mild to moderate tricuspid regurgitation should be addressed, while others take a more conservative approach. Infective endocarditis or traumatic lesions are other indications. [14]
Tricuspid regurgitation is usually secondary to right ventricular dilation [16] which may be due to left ventricular failure (the most common cause), right ventricular infarction, inferior myocardial infarction, [16] or cor pulmonale [16] Other causes of tricuspid regurgitation include carcinoid syndrome and myxomatous degeneration.
In The Framingham Heart Study presence of any severity of tricuspid regurgitation, ranging from trace to above moderate was in 82% of men and in 85.7% of women. [2] Mild tricuspid regurgitation tend to be common and benign and in structurally normal tricuspid valve apparatus can be considered a normal variant. [1]
Since the main causes of right ventricular hypertrophy is tricuspid regurgitation or pulmonary hypertension (discussed above), management involves treatment of these conditions. [3] Tricuspid regurgitation is typically treated conservatively by aiming to treat the underlying cause and following up the patient regularly. [12]
Causes include mitral valve prolapse, tricuspid valve prolapse and papillary muscle dysfunction. Holosystolic (pansystolic) murmurs start at S1 and extend up to S2. They are usually due to regurgitation in cases such as mitral regurgitation, tricuspid regurgitation, or ventricular septal defect (VSD).
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