Name
TRICUSPID STENOSIS
DESCRIPTION
DETAIL
CAUSES : - RHEUMATIC - CONGENITAL - ACUTE BACTERIAL ENDOCARDITIS - CARCINOID HEART DISEASE - METABOLIC OR ENZYMATIC ABNORMALITIES LIKE FABRY DISEASE , GIANT BLOOD CYSTS -------------------------------------------------------------------------- D.D. : - ATRIAL MYXOMA - CARDIOMYOPATHY, RESTRICTIVE - ENDOMYOCARDIAL FIBROSIS - INFECTIVE ENDOCARDITIS - PERICARDITIS, CONSTRICTIVE - PERICARDITIS, CONSTRICTIVE-EFFUSIVE - TRICUSPID ATRESIA* CBC - MAY INDICATE INFECTION * ECG - SHOW ONLY RA ENLARGEMENT WITHOUT RV HYPERTROPHY * CARDIAC CATHETERIZATION
TYPENOTES
Medical Care: In the treatment of tricuspid stenosis, medical care consists of assessment and treatment of the underlying cause of the valvular pathology. " Treat bacterial endocarditis with the appropriate antibiotics as determined by the sensitivity of the organisms cultured. " Medically address cardiac arrhythmias depending on their characterization. " Decreasing volume overload with diuresis and salt restriction helps decrease symptoms and improve hepatic function. Surgical Care: Tricuspid stenosis remains a surgical disease and requires either commissurotomy or replacement of the valve if right heart failure or low cardiac output has resulted. Surgery is rarely performed solely on the tricuspid valve. It is usually performed in combination with mitral and/or aortic valve disease repair. " With tricuspid valve replacement, the risk of thrombosis is significant and many surgeons advise warfarin therapy for either mechanical or bioprosthetic valve placement. " Percutaneous balloon valvuloplasty has been used successfully, as long as concomitant regurgitation is not significant. " The therapy chosen depends on the structure of the valve and the degree of deformity encountered. " When possible, excise intracavitary pathology, whether it be tumors or other structural abnormalities. " Redundant portions of the dilated right atrium can be excised during the same procedure for restoring the atrium back to normal size. Diet: " No specific dietary restrictions are necessary before therapy. " Fluid and sodium restriction is prudent if signs of venous congestion are present. " If a valve replacement is undertaken and the patient must be anticoagulated, dietary instructions must be provided regarding those foods that interfere with anticoagulation and are rich in vitamin K. Activity: " Activity is usually self-limited by the patient because of easy fatigability secondary to oxygen deprivation. " Once the pathology has been corrected, no activity restrictions are necessary. DRUG TREATMENT : 1. ANTIARRHYTHMIC AENTS : - DIGOXIN 2. ANTICOAGULANTS : -. WARFARIN
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
X-RAY CHEST P.A. VIEW( NORMAL ), COMPLETE BLOOD COUNT, ECHOCARDIOGRAPHY, ECG, CARDIAC DOPPLER