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Regurgitação tricúspide

Última revisión: 20 八月 2025
Última actualización: 21 三月 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presença de fatores de risco
  • fadiga e intolerância ao esforço
  • dispneia
  • palpitações
  • anormalidade venosa jugular
  • ritmo cardíaco irregular
  • sopro sistólico paraesternal
  • aumento do sopro sistólico na inspiração (sinal de Carvallo)
  • edema periférico
Todos los datos

Otros factores de diagnóstico

  • distensão abdominal
  • saciedade precoce, dispepsia
  • pulsação do fígado
Todos los datos

Factores de riesgo

  • insuficiência cardíaca esquerda
  • anel tricúspide dilatado
  • doença reumática cardíaca
  • marca-passo permanente
  • endocardite
  • cardiopatia carcinoide
  • encarceramento do fio do marca-passo
  • cardiomiopatia isquêmica
  • pericardite constritiva
  • cardiopatia congênita
  • toxinas
  • artrite reumatoide
  • radioterapia
  • trauma
  • Síndrome de Marfan
  • prolapso da valva tricúspide
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • ecocardiograma transesofágico ou transtorácico
  • eletrocardiograma (ECG)
  • TFHs
  • ureia e creatinina séricas
  • Hemograma completo
  • radiografia torácica
Todos los datos

Pruebas diagnósticas que deben considerarse

  • ecocardiografia transesofágica cirúrgica
  • ecocardiografia transtorácica pós-operatória
  • cateterismo cardíaco
  • ressonância nuclear magnética (RNM) cardíaca (técnica preferida para avaliação do tamanho e da função do ventrículo direito)
Todos los datos

Algoritmo de tratamiento

Agudo

primária: leve ou moderada

primária: grave

secundária: leve ou moderada

secundária: grave

Colaboradores

Autores

Shahab A. Akhter, MD

Professor of Cardiothoracic

Division of Cardiac Surgery

Department of Cardiovascular Sciences

Brody School of Medicine

East Carolina University

Greenville

NC

Divulgaciones

SAA declares that he has no competing interests.

Paul Tang, MD, PhD

Assistant Professor

Department of Cardiac Surgery

University of Michigan

Ann Arbor

MI

Divulgaciones

PT declares that he has no competing interests.

Jarred Mondonedo, MD, PhD

Cardiothoracic Surgery Fellow

Department of Cardiac Surgery

University of Michigan

Ann Arbor

MI

Divulgaciones

JM declares that he has no competing interests.

Agradecimientos

Dr Shahab A. Akhter and Dr Paul Tang would like to gratefully acknowledge Dr Kevin L. Greason, Dr Sorin V. Pislaru, and Prof. Thoraf M. Sundt III, previous contributors to this topic.

Divulgaciones

KLG, SVP, and TMS declare that they have no competing interests.

Revisores por pares

Larry A. Weinrauch, MD

Assistant Professor of Medicine

Harvard Medical School

Watertown

MA

Divulgaciones

LAW declares that he has no competing interests.

Prakash P. Punjabi, MB BS

Consultant Cardiothoracic Surgeon

Imperial College Healthcare NHS Trust

London

UK

Divulgaciones

PPP declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Shah PM, Raney AA. Tricuspid valve disease. Curr Probl Cardiol. 2008 Feb;33(2):47-84. Resumen

Vahanian A, Beyersdorf F, Praz F, et al; ESC/EACTS Scientific Document Group; ESC Scientific Document Group. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 28 Aug 2021 [Epub ahead of print].Texto completo  Resumen

Lancellotti P, Moura L, Pierard LA, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr. 2010 May;11(4):307-32.Texto completo  Resumen

Writing Committee Members., Otto CM, Nishimura RA, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021 Feb 2;77(4):e25-e197.Texto completo  Resumen

Abbas M, Hamilton M, Yahya M, et al. Pulsating varicose veins!! The diagnosis lies in the heart. ANZ J Surg. 2006 Apr;76(4):264-6. Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

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