Tricuspid prolapse

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Overview
Tricuspid prolapse is defined as abnormal protrusion of one or more of the leaflets of the tricuspid valve into the right atrium during systole.

Incidence
Among 100 patients undergoing both right and left ventriculography, a total of 27 patients had tricuspid valve prolapse, and and a total of 15 patients had mitral valve prolapse. Among the 27 patients with tricuspid valve prolapse, 19 patients had prolapse isolated to the tricuspid valve, while eight patients had both tricuspid and mitral valve prolapse. Statistically, tricuspid valve prolapse was significantly associated with mitral valve prolapse (p < 0.02). Tricuspid valve prolapse was also associated with a higher right-ventricular ejection fraction (58 + 10 vs 53 +/- 10%; p less than 0.05) as well as smaller end-systolic right ventricular volume indices (39 +/- 16 vs 47 +/- 17 ml/m2; p less than 0.05).

Echocardiographic Findings
In 1975 Chandraratna et al described the echocardiographic findings among 12 patients with tricuspid valve prolapse. Eight of the 12 patients also had associated mitral valve prolapse. Tricuspid regurgitation was observed in one patient.

Echocardiographic Patterns
The authors described two patterns of abnormality:
 * 1) Eight of 12 patients demonstrated an initial horizontal motion followed by a posterior motion in midsystole.
 * 2) The other 4 of 12 patients demonstrated posterior motion of the tricuspid valve in early systole, which reached a maximum in midsystole, which was then followed by an anterior motion.

Association with other disease states
There are some data to suggest that tricuspid valve prolapse is associated with psoriasis.

Clinical Significance
The clinical significance of tricuspid valve prolapse is unclear.