Tricuspid Valve

What is the tricuspid valve?

The tricuspid valve is one of four valves in the heart. It’s located between the right lower heart chamber (right ventricle) and the right upper heart chamber (right atrium).

The tricuspid valve opens and closes to ensure that blood flows in the correct direction. It’s also called the right atrioventricular valve.

What does the tricuspid valve do?

The heart pumps blood in a specific route through four chambers (two atria and two ventricles). Every time your heart beats, the atria receive oxygen-poor blood from the body. And the ventricles contract (squeeze) to pump blood out.

As the heart pumps, valves open and close to allow blood to move from one area of the heart to another. The valves help ensure that blood flows at the right time and in the correct direction.

The tricuspid valve ensures that blood flows from the right atrium to the right ventricle. It also prevents blood from flowing backward between those two chambers. When the right atrium fills, the tricuspid valve opens, letting blood into the right ventricle. Then the right ventricle contracts to send blood to the lungs. The tricuspid valve closes tightly so that blood does not go backward into the right atrium.

Where is the tricuspid valve?

The tricuspid valve is located between the right lower heart chamber (right ventricle) and the right upper heart chamber (right atrium). It’s positioned vertically (up and down).

What is the tricuspid valve made of?

The tricuspid valve is made of three thin but strong flaps of tissue. They’re called leaflets or cusps. The leaflets are named by their positions: anterior, posterior and septal. They attach to the papillary muscles of the ventricle with thin, strong cords called chordae tendineae.

With every heartbeat, those leaflets open and close. The sounds of the heart valves opening and closing are the sounds you hear in a heartbeat.

What conditions and disorders can affect the right atrioventricular valve?

If the tricuspid valve isn’t functioning as it should, blood may not flow efficiently in the correct direction or it may leak in the wrong direction. Your heart may have to work harder to pump enough blood to the rest of your body.

There are three main types of tricuspid valve problems:

• Tricuspid atresia: Tricuspid atresia is a structural heart defect that’s present at birth. A person with this condition has a solid piece of tissue where the valve should be. This limits blood flow and can lead to underdevelopment of the right ventricle. It usually requires surgery.
• Tricuspid regurgitation: This condition means blood is leaking backward through the tricuspid valve.
• Tricuspid stenosis: In this condition, the tricuspid valve opening is too narrow, restricting blood flow between the two chambers.

Several factors can cause problems with the tricuspid valve, including:

• Cardiac tumor or radiation to the chest to treat cancer.
• Congenital defect (a structural problem present at birth, such as the valve having only two leaflets or having more than three leaflets).
• Disorders that affect your body’s connective tissue, such as Marfan syndrome.
• Recreational drug use.
• Enlarged right ventricle.
• Infection that causes swelling in the heart muscle, such as endocarditis or rheumatic fever.
• Use of a diet drug called “fen-phen” (fenfluramine and phentermine).

What are the symptoms of tricuspid valve problems?

When the tricuspid valve isn’t functioning normally, your heart might have to work harder to pump blood. This can lead to fatigue and weakness.

If a tricuspid condition gets worse over time, it can also cause:

• Cold skin.
• Enlarged liver.
• Heart murmur, a swishing sound heard through a stethoscope when the heart beats.
• Palpitations or a fluttering feeling in the chest.
• Pulsing in the veins in the neck.
• Swelling in the belly, legs, ankles or feet.

What tests can determine whether my heart valves are working properly?

If a healthcare provider suspects you have a problem with the tricuspid valve, you may need a cardiologist. A cardiologist is a doctor who specializes in diagnosing and treating heart problems.

Several tests can help examine the tricuspid valve:

• Physical exam: During a physical exam, the healthcare provider will listen to the heartbeat with a stethoscope.
• Chest imaging: A chest X-ray or cardiac MRI takes pictures of the inside of the chest.
• Echocardiogram: An echocardiogram is one of the main tests to diagnose problems with the heart valves. Also called an echo, this test creates moving pictures of the heart’s chambers, valves and pumping action.
• Electrocardiogram (ECG): An electrocardiogram, also called an ECG or EKG, measures the electrical activity of the heart.
• Exercise stress test: During an exercise stress test, you will walk on a treadmill while a healthcare provider measures heart function.
• Cardiac catheterization: Cardiac catheterization can determine if there is any backward flow of blood and show how much the tricuspid valve is opening. During the procedure, a healthcare provider threads a long, thin tube called a catheter through a blood vessel into the heart.

What treatments are available for conditions involving the tricuspid valve?

A tricuspid valve condition may require treatment or continued monitoring depending on the severity of your valve problem and your symptoms.

If treatment is warranted, your healthcare provider may recommend:

• Diuretics: These drugs can help reduce swelling associated with tricuspid valve disorders.
• Tricuspid valve repair: A surgeon can reshape, widen or tighten the leaflets in the tricuspid valve. Surgery can also strengthen or tighten the tricuspid valve by implanting an artificial ring.
• Tricuspid valve replacement: A surgeon can replace the tricuspid valve with an artificial mechanical valve or a biological valve from an animal.
• Transcatheter valve repair: If you have severe and symptomatic tricuspid valve regurgitation, an interventional cardiologist may repair the valve through the skin (percutaneous repair).
• Transcatheter valve replacement: Your interventional radiologist may offer percutaneous valve replacement if you have severe and symptomatic tricuspid valve regurgitation.

If I have tricuspid stenosis or tricuspid regurgitation, how can I keep my heart healthier?

If you have a tricuspid valve condition, you can help keep your heart healthier and prevent complications with these strategies:

• Avoid smoking.
• Control your blood pressure and cholesterol.
• Eat a heart-healthy diet that’s low in saturated and trans fats and loaded with fruits and veggies.
• Exercise regularly.
• Have regular checkups with a primary care provider so he or she can listen to your heart and catch any problems early.
• Take antibiotics before dental and other procedures.
• Tell all of your healthcare providers, including your dentist, that you have a heart valve issue.

If I have a tricuspid valve issue, when should I call a healthcare provider?

If you have a tricuspid valve problem, you should immediately report any signs of infection. This will help you catch and treat endocarditis (heart infection) early. Call your healthcare provider right away if you have signs of infection, such as body aches, fever or sore throat. You should also attend all appointments to have your heart checked regularly.

A note from Cleveland Clinic

The tricuspid valve is one of four heart valves. It ensures that blood flows from the right atrium to the right ventricle at the right time and in the right direction. If the tricuspid valve isn’t working properly, your healthcare provider may recommend regular checkups or surgery to repair or replace the faulty valve.