Abstract
Twelve patients are presented with rheumatic valve lesions and a typical tricuspid diastolic rumble presenting inspiratory accentuation. All the patients, except one, were in sinus rhythm. No tricuspid diastolic gradient was found when they were first catheterized. An intracardiac diastolic rumble with inspiratory accentuation was recorded in the right atrium or ventricle, or both. Five of the patients were recatheterized after an interval of 1 to 3 years, and, although the clinical picture was unchanged, small tricuspid gradients were recorded. A diminution of cardiac output and an increase of right atrial mean pressure were also observed. It should be accepted that, at an early stage of tricuspid stenosis, a tricuspid gradient may be absent while the auscultatory and phonocardiographic signs may be the only indication of the tricuspid lesion.
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