Abstract
Tricuspid stenosis is a very rare valvular disease due to narrowing of the orifice of the tricuspid valve of the heart. It is usually of rheumatic origin which is accompanied by other valvular lesions. Other causes of tricuspid stenosis include carcinoid syndrome, endocarditis, endomyocardial fibrosis, lupus erythematosus, right atrial myxoma, drug induced and congenital tricuspid atresia. Here we report a patient who had undergone percutaneous transluminal mitral commissurotomy (PTMC) followed by mitral restenosis with Severe Tricuspid Stenosis with Severe Tricuspid Regurgitation.
Highlights
Tricuspid Stenosis(TS) accounts for about 2.4% of all cases of organic tricuspid valve disease and is mostly seen in young women. 1 The congenital form of the disease has a slightly higher male predominance. 2 Around 15 % patients with rheumatic heart disease at autopsy show evidence of TS
Other causes of tricuspid stenosis include carcinoid syndrome, endocarditis, endomyocardial fibrosis, lupus erythematosus, congenital tricuspid atresia, extracardiac tumours, pacemaker lead and fusion of implantable cardioverter defibrillator leading to sub-valvular structures damage. 4,5
She has been managed with medical therapy including diuretics, oral penicillin, warfarin and digoxin. She has been treated with metformin and thyroxine for Diabetes Mellitus (DM) and hypothyroidism. She has been advised for surgical treatment including mitral commissurotomy with Tricuspid valve repair or replacement
Summary
Tricuspid Stenosis(TS) accounts for about 2.4% of all cases of organic tricuspid valve disease and is mostly seen in young women. 1 The congenital form of the disease has a slightly higher male predominance. 2 Around 15 % patients with rheumatic heart disease at autopsy show evidence of TS. 46 years female, farmer by occupation and residing in a remote village of Nepal presented with NYHA-III shortness of breath and swelling of the body for 6 months She has past history of Percutaneous Transluminal Mitral Commissurotomy (PTMC) done in 2013 AD for symptomatic severe rheumatic mitral stenosis. Clinical examination revealed irregular pulse with pulse deficit of 20 bpm, bilateral pitting pedal edema, raised Jugular Venous Pressure (JVP), tapping apex, Left parasternal heave, Apical mid-diastolic thrill, Left lower border Mid-diastolic murmur, Pansystolic murmur over tricuspid area and inspiratory basal crackles over chest. She has been managed with medical therapy including diuretics, oral penicillin, warfarin and digoxin. She has been advised for surgical treatment including mitral commissurotomy with Tricuspid valve repair or replacement
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