Mild tr in echo test

• • Raised artery pulmonary pressure (PAP) is associated with increased mortality. • • We review the eight published echo techniques to assess PAP by echocardiography. • • Knowledge of all the echo techniques could avoid need for invasive tests. • • A scoring system combining various echo-derived measurements of PAP is needed. Pulmonary hypertension is a pathological haemodynamic condition defined as an increase in mean pulmonary arterial pressure≥25mmHg at rest, assessed using gold standard investigation by right heart catheterisation. Pulmonary hypertension could be a complication of cardiac or pulmonary disease, or a primary disorder of small pulmonary arteries. Elevated pulmonary pressure (PAP) is associated with increased mortality, irrespective of the aetiology. The gold standard for diagnosis is invasive right heart catheterisation, but this has its own inherent risks. In the past 30years, immense technological improvements in echocardiography have increased its sensitivity for quantifying pulmonary artery pressure (PAP) and it is now recognised as a safe and readily available alternative to right heart catheterisation. In the future, scores combining various echo techniques can approach the gold standard in terms of sensitivity and accuracy, thereby reducing the need for repeated invasive assessments in these patients. • Previous article in issue • Next article in issue

Mild tricuspid regurgitation and borderline pulmonary arterial hypertension –Echocardiogram video Echocardiogram video with narration Apical four chamber view showing mild TR Apical four chamber view with colour flow mapping demonstrates mild tricuspid regurgitation (TR) as a bluish mosaic jet into the right atrium. RA: right atrium; LA: left atrium; LV: left ventricle; LA: left atrium. Both mitral and tricuspid valves are in closed position, indicating a systolic frame. TR jet area occupies only a small portion of the right atrial area, qualifying for mild tricuspid regurgitation. Interventricular septum (between RV and LV) atrioventricular septum (between the septal attachments of the mitral and tricuspid valves) and the interatrial septum (between RA and LA) are clearly seen in this view. Apical four chamber view with mitral valve fully closed Apical four chamber view without color flow mapping. STL: septal tricuspid leaflet; AML: anterior mitral leaflet. The region of the septum between the STL and AML is the atrioventricular septum. If there is a defect in this region of the septum it will cause and LV-RA shunt and it is called Gerbode VSD (ventricular septal defect). If the STL is attached far distally, then it is called Ebstein’s anomaly of the tricuspid valve, in which a portion of the right ventricle becomes atrialised. Apical four chamber view with mitral valve partially open Apical four chamber view with mitral and tricuspid valves partially open. The STL and AM...

What is Tricuspid Valve Regurgitation? Tricuspid regurgitation is leakiness of the tricuspid valve. The tricuspid valve is valve between the upper and lower chambers of the right side of the heart. Everyone has heard of the valve between the upper and lower chambers of the left side of the heart, the At myheart.net we’ve helped millions of people through our articles and answers. Now our authors are keeping readers up to date with cutting edge heart disease information through twitter. Follow Dr Ahmed on Twitter @MustafaAhmedMD [wp_hyena imageurl=’https://myheart.net/wp-content/uploads/2015/07/Tricuspid-Regurgitation.gif’ data_hyena='’] Causes In general tricuspid regurgitation can be thought of as primary or secondary. In primary tricuspid regurgitation the tricuspid valve leaflets or the chords that attach the valve to the heart pumping chambers themselves are affected. In secondary tricuspid regurgitation the leaflets and chords themselves are not primarily affected, rather there is a process called annular dilation. The Several things can cause primary tricuspid regurgitation, where the leaflets and/or chords are affected. These include valve infection, traumatic causes, birth defects and damage from pacemaker leads amongst other causes. Secondary tricuspid regurgitation is caused by factors leading to annulus enlargement, such as right ventricular failure or enlargement, or severely elevated pressures in the right side of the heart such as pulmonary hypertension. Even...

Tricuspid regurgitation The tricuspid valve separates the right ventricle and the right atrium. It normally consists of three leaflets (anterior, posterior and septal leaflet). The leaflets are attached to the subvalvular apparatus, consisting of the chordae tendineae and the papillary muscles. As compared to the mitral valve, the tricuspid valve is located slightly more apically (0.8 mm/m 2 BSA. • Basal segments of the right ventricle (i.e parts on the atrial side of the tricuspid annulus) function as atrium and becomes dilated. • The anterior leaflet is usually larger. It may be fenestrated and swing into the RVOT, obstructing the outflow. Reumatic heart disease • Thickened chordae tendineae. • Thickened leaflet tips. • Reduced leaflet mobility. • Left-sided rheumatic valvular disease is virtually always present. Carcinoid heart disease • Short, thick and rigid leaflets. Echocardiography Right ventricular dimensions and function must always be assessed. Left ventricular function, which may be the origin of right ventricular dysfunction, must also be evaluated. The pulmonary, aortic and mitral valve must also be evaluated, particularly in the setting of rheumatic valvular disease. The regurgitation is considered severe if the tricuspid annulus diameter is >4 cm. Severe tricuspid regurgitation results in right ventricular and atrial dilation. Tricuspid regurgitation leads to pressure and volume overload in the right ventricle. This results in the septum bulging into the le...

Thanks Kenkeith. Ignoring MR and TR, I am still confused on what would have caused my high BP because being a vegitarian I always thought my sodium intake is on a lower side and I don't take alcohol and don't smoke. I am moderately active. My father and mother both are hypertensive. Could that be the problem? If I manage my high BP, will that do in the long run? Mild, trace description of valve leakage is considered medically insignificance.Almost always there is no progression or problems.The usual cause are leaflets don't completely and tightly close off any backflow into the atrium (upper chamber) when the lower chamber pumps blood into circulation.Sometimes the opening may be slightly irregular or the chords that attach the leaflets to heart muscles can be slightly elongated and there is slight prolapse of the leaflets. Untreated high blood pressure. Over time, high blood pressure can cause your heart to work harder and gradually your heart's left ventricle can enlarge. This can then stretch the tissue around your mitral valve, which can lead to leakage.That occurred to me....

Mild tricuspid regurgitation and borderline pulmonary arterial hypertension –Echocardiogram video Echocardiogram video with narration Apical four chamber view showing mild TR Apical four chamber view with colour flow mapping demonstrates mild tricuspid regurgitation (TR) as a bluish mosaic jet into the right atrium. RA: right atrium; LA: left atrium; LV: left ventricle; LA: left atrium. Both mitral and tricuspid valves are in closed position, indicating a systolic frame. TR jet area occupies only a small portion of the right atrial area, qualifying for mild tricuspid regurgitation. Interventricular septum (between RV and LV) atrioventricular septum (between the septal attachments of the mitral and tricuspid valves) and the interatrial septum (between RA and LA) are clearly seen in this view. Apical four chamber view with mitral valve fully closed Apical four chamber view without color flow mapping. STL: septal tricuspid leaflet; AML: anterior mitral leaflet. The region of the septum between the STL and AML is the atrioventricular septum. If there is a defect in this region of the septum it will cause and LV-RA shunt and it is called Gerbode VSD (ventricular septal defect). If the STL is attached far distally, then it is called Ebstein’s anomaly of the tricuspid valve, in which a portion of the right ventricle becomes atrialised. Apical four chamber view with mitral valve partially open Apical four chamber view with mitral and tricuspid valves partially open. The STL and AM...

Tricuspid regurgitation The tricuspid valve separates the right ventricle and the right atrium. It normally consists of three leaflets (anterior, posterior and septal leaflet). The leaflets are attached to the subvalvular apparatus, consisting of the chordae tendineae and the papillary muscles. As compared to the mitral valve, the tricuspid valve is located slightly more apically (0.8 mm/m 2 BSA. • Basal segments of the right ventricle (i.e parts on the atrial side of the tricuspid annulus) function as atrium and becomes dilated. • The anterior leaflet is usually larger. It may be fenestrated and swing into the RVOT, obstructing the outflow. Reumatic heart disease • Thickened chordae tendineae. • Thickened leaflet tips. • Reduced leaflet mobility. • Left-sided rheumatic valvular disease is virtually always present. Carcinoid heart disease • Short, thick and rigid leaflets. Echocardiography Right ventricular dimensions and function must always be assessed. Left ventricular function, which may be the origin of right ventricular dysfunction, must also be evaluated. The pulmonary, aortic and mitral valve must also be evaluated, particularly in the setting of rheumatic valvular disease. The regurgitation is considered severe if the tricuspid annulus diameter is >4 cm. Severe tricuspid regurgitation results in right ventricular and atrial dilation. Tricuspid regurgitation leads to pressure and volume overload in the right ventricle. This results in the septum bulging into the le...

What is Tricuspid Valve Regurgitation? Tricuspid regurgitation is leakiness of the tricuspid valve. The tricuspid valve is valve between the upper and lower chambers of the right side of the heart. Everyone has heard of the valve between the upper and lower chambers of the left side of the heart, the At myheart.net we’ve helped millions of people through our articles and answers. Now our authors are keeping readers up to date with cutting edge heart disease information through twitter. Follow Dr Ahmed on Twitter @MustafaAhmedMD [wp_hyena imageurl=’https://myheart.net/wp-content/uploads/2015/07/Tricuspid-Regurgitation.gif’ data_hyena='’] Causes In general tricuspid regurgitation can be thought of as primary or secondary. In primary tricuspid regurgitation the tricuspid valve leaflets or the chords that attach the valve to the heart pumping chambers themselves are affected. In secondary tricuspid regurgitation the leaflets and chords themselves are not primarily affected, rather there is a process called annular dilation. The Several things can cause primary tricuspid regurgitation, where the leaflets and/or chords are affected. These include valve infection, traumatic causes, birth defects and damage from pacemaker leads amongst other causes. Secondary tricuspid regurgitation is caused by factors leading to annulus enlargement, such as right ventricular failure or enlargement, or severely elevated pressures in the right side of the heart such as pulmonary hypertension. Even...

• • Raised artery pulmonary pressure (PAP) is associated with increased mortality. • • We review the eight published echo techniques to assess PAP by echocardiography. • • Knowledge of all the echo techniques could avoid need for invasive tests. • • A scoring system combining various echo-derived measurements of PAP is needed. Pulmonary hypertension is a pathological haemodynamic condition defined as an increase in mean pulmonary arterial pressure≥25mmHg at rest, assessed using gold standard investigation by right heart catheterisation. Pulmonary hypertension could be a complication of cardiac or pulmonary disease, or a primary disorder of small pulmonary arteries. Elevated pulmonary pressure (PAP) is associated with increased mortality, irrespective of the aetiology. The gold standard for diagnosis is invasive right heart catheterisation, but this has its own inherent risks. In the past 30years, immense technological improvements in echocardiography have increased its sensitivity for quantifying pulmonary artery pressure (PAP) and it is now recognised as a safe and readily available alternative to right heart catheterisation. In the future, scores combining various echo techniques can approach the gold standard in terms of sensitivity and accuracy, thereby reducing the need for repeated invasive assessments in these patients. • Previous article in issue • Next article in issue

Thanks Kenkeith. Ignoring MR and TR, I am still confused on what would have caused my high BP because being a vegitarian I always thought my sodium intake is on a lower side and I don't take alcohol and don't smoke. I am moderately active. My father and mother both are hypertensive. Could that be the problem? If I manage my high BP, will that do in the long run? Mild, trace description of valve leakage is considered medically insignificance.Almost always there is no progression or problems.The usual cause are leaflets don't completely and tightly close off any backflow into the atrium (upper chamber) when the lower chamber pumps blood into circulation.Sometimes the opening may be slightly irregular or the chords that attach the leaflets to heart muscles can be slightly elongated and there is slight prolapse of the leaflets. Untreated high blood pressure. Over time, high blood pressure can cause your heart to work harder and gradually your heart's left ventricle can enlarge. This can then stretch the tissue around your mitral valve, which can lead to leakage.That occurred to me....