Right Sided Valvular Heart Disease

Your Path

  • Right sided valvular heart disease


  • Primary Pulmonary stenosis or regurg → almost always congenital
  • Tricuspid regurg, Secondary process: Etiology includes from L sided CHF, Pulm htn, etc
  • Tricuspid regurg, Primary valvular abnormality: Etiology includes endocarditis; direct damage from trauma; associated w/carcinoid
  • Tricuspid stenosis: Etiology includes very uncommon congenital, tumor, carcinoid


  • Ascites
  • Peripheral edema
  • If endocarditis: fever, chills, sweats, sob (septic pulmonary emboli)
  • If carcinoid: episodic flushing, diarrhea, cramps, wheezing, SOB
  • If pulmonary hypertension → SOB, DOE

Physical Exam Findings

  • Dynamic JVP, with easily visible V waves w/tricuspid regurg
  • Murmur of TR: holosytolic murmur, loudest at lower left sternal border, augmented when pressure applied to liver area (increased venous return)