- 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
- Peripheral edema
- If endocarditis: fever, chills, sweats, sob (septic pulmonary emboli)
- If carcinoid: episodic flushing, diarrhea, cramps, wheezing, SOB
- If pulmonary hypertension → SOB, DOE
- 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)
- Cardiac echo
- If ascites, tap with elevated SAAG, elevated TP