Chonnam Med J.  2015 Dec;51(3):135-138. 10.4068/cmj.2015.51.3.135.

Tachycardia-Induced Right Heart Failure and Severe Tricuspid Regurgitation That Improved with Medication

• Yang YA
• Yang DH
• Kim HN
• Kwon SH
• Jang SY
• Bae MH
• Lee JH
• Chae SC

• KMID: 2172130
• DOI: http://doi.org/10.4068/cmj.2015.51.3.135

Abstract

Secondary tricuspid regurgitation (TR) primarily develops due to left heart failure or primary pulmonary diseases. Tricuspid annular dilation, which is commonly caused by right ventricular volume and pressure overload followed by right ventricle dilation, is believed to be the main mechanism underlying secondary TR. It is reported that once the tricuspid annulus is dilated, its size cannot spontaneously return to normal, and it may continue to dilate. These reports also suggest the use of an aggressive surgical approach for secondary TR. In the present report, we describe a case of tachycardia-induced severe TR that was completely resolved without the need for surgery.

Keyword

Tricuspid valve insufficiency; Cardiomyopathies; Tachycardia

MeSH Terms

Cardiomyopathies
Heart Failure*
Heart Ventricles
Heart*
Lung Diseases
Tachycardia
Tricuspid Valve Insufficiency*

Figure

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  FIG. 1 (A) An initial electrocardiogram showing narrow QRS tachycardia with a rapid ventricular rate. (B) An electrocardiogram on the second day of admission showing sinus bradycardia.

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  FIG. 2 (A) An apical four-chamber image showing dilation of the right ventricle and right atrium. (B) A color Doppler image showing severe tricuspid valve regurgitation. (C) An apical four-chamber image showing tricuspid annulus dilation with severe incomplete coaptation of the tricuspid valve leaflets during systole. (D) Hepatic vein Doppler image showing systolic reversal flow.

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  FIG. 3 (A) An apical four-chamber image showing significantly decreased sizes of the right ventricle and atrium compared to sizes on the previous images (Fig. 2). (B) A color Doppler image showing a marked reduction of the tricuspid regurgitation flow. (C) Image showing reduction of the tricuspid annulus dilation to 3.23 cm. (D) Hepatic vein Doppler image showing no systolic reversal flow.

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