Clinical presentation

Usually presents secondary to the symptoms of the primary problem e.g. congestive cardiac failure with the tricuspid regurgitation occurring as a consequence of the heart failure.

Features may include:

• fatigue secondary to decreased cardiac output.
• features of a raised right atrial pressure e.g. ascites and dependent oedema.
• atrial fibrillation may occur,
• jugular venous pressure - high large systolic wave seen in the neck. The 'y' descent is often sharp.
• hyperkinetic right ventricle -> marked pulsation at the left sternal edge.
• on auscultation - pansystolic murmur heard at the lower end of the sternum. Note that if there is right ventricular dilatation then the murmur may be heard at apex and so be difficult to distinguish from mitral regurgitation. The murmur is louder on inspiration.
• pulsatile hepatomegaly.