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Tricuspid valve

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The function of the tricuspid valve is to prevent back flow of blood from the right ventricle into the right atrium.

The normal tricuspid valve usually has three leaflets, named the anterior, posterior, and septal leaflets.

Each leaflet is connected via chordae tendineae to the anterior, posterior, and septal papillary muscles of the right ventricle, respectively.

Tricuspid valves may also occur with two or four leaflets.

The number of tricuspid leaflets may change over a lifetime.

The tricuspid valve is the largest valve in the heart, and typically has three leaflets of unequal size.

The number of valve leaflets may vary, with the most common variant consisting of two posterior leaflets.

Tricuspid valve leaflets, are thinner than mitral valve, leaflets, and are supported by chordae attached to major anterior papillary muscle along the lateral wall of the mid right ventricle, as well as smaller posterior papillary muscles.

Posterior papillary muscles supply chordae to the posterior leaflet, and the posterior segment of the septal leaflet.

The complex chordal arcades and attachments make the tricuspid valve sensitive to changes in the position and function of the free wall of the right ventricle and of the interventricular septum.

The tricuspid valve closes during ventricular systole acting as a one way valve to prevent regurgitation of blood from the right ventricle back into the right atrium.

During ventricular diastole it opens, allowing blood to flow from the right atrium into right ventricle.

The back flow of blood is also known as tricuspid regurgitation.

Tricuspid regurgitation can result in increased ventricular preload as the blood refluxed back into the atrium is added to the volume of blood that must be pumped back into the ventricle during the next cycle of ventricular diastole.

Increased right ventricular preload over a prolonged period of time may lead to right ventricular enlargement which can progress to right heart failure.

Tricuspid regurgitation is not uncommon.

Infected valves involving the right side of the heart can result in endocarditis in intravenous drug users.

In patients without a history of intravenous exposure, endocarditis is more frequently left-sided.

Or it can be affected by rheumatic fever, which can cause tricuspid stenosis or tricuspid insufficiency.

Females have a larger annulus, which is saddle shaped and dynamic, larger in early diastole, and during atrial systole, which  allows  for large flow volumes under low pressure.

As little as 40% of annular dilatation may result in clinically significant tricuspid regurgitation.

 

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