Tricuspid insufficiency (TI) is a disorder of the heart in which the normal flow of blood is hindered because of a leakage of blood backward through the tricuspid valve with each contraction of the right ventricle. This conditions usually develops when the right ventricle of the heart becomes enlarged, creating resistance to the forward flow of blood toward the lungs where it is oxygenated and delivers up carbon dioxide. Understanding of tricuspid insufficiency requires a basic knowledge of the anatomy of the heart, which is divided into four chambers through which blood flows: the upper chambers, consisting of the right and left atria; and the lower chambers, called the right and left ventricles. Valves are structures in the heart that open and close, much like doors, to maintain the flow of blood in only one direction at a time.
When heart valves malfunction, leakage or regurgitation of blood within the chambers can occur. This is why tricuspid insufficiency is also called tricuspid regurgitation or tricuspid incompetence. It is the tricuspid valve that sits between the right atrium and the right ventricle, which receive blood from the body on its way back to the heart to be sent to the lungs. Tricuspid insufficiency simply indicates that this particular valve is not opening and closing properly to keep all of the blood flowing in one direction all of the time. Blood is permitted to leak through and be regurgitated up into the right atrium, resulting in an insufficiency in cardiac activity overall.
As resistance to blood flow to the lungs from the right ventricle increases, this lower chamber of the heart begins to enlarge and thicken in an attempt to have more power to pump harder to do its job. The valve opening also stretches. This is when tricuspid insufficiency is said to actually result. Serious lung disorders such as emphysema, pulmonary hypertension or a narrowing of the pulmonary valve can increase resistance in proper blood flow through the heart. Other causes of the condition that are less common include an infection of the valves of the heart, injury to these structures, birth defects of any specific valve and inherited disorders that cause a valve to become floppy over time.
Signs and symptoms of tricuspid insufficiency can be mild, or they can be severe, depending on how long the condition has persisted. Weakness and general fatigue set in because the heart is pumping insufficient amounts of blood, which means that circulation to all tissues of the body is not optimal. Pulsations in the neck might be experienced as well as rapid and irregular heartbeats until heart failure eventually develops. Patients might also experience the accumulation of fluids in the body, particularly in the legs. Diagnosis of tricuspid insufficiency generally involves the review of a patient's medical history, an X-ray of the chest, electrocardiography to produce images showing any leakage and listening to the heart with a stethoscope.
