Tricuspid Valve Dysplasia
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- Common in dogs & cats
- Rare in large animals
- Horses do get tricuspid atresia
Signalment
Genetics & Predisposed Breeds: Labrador Retrievers, German Shepherds, Boxers, Great Danes
Description
- Congenital malformation of the tricuspid valve (right atrioventricular valve) and its supporting structures (chordae tendineae, papillary muscles, valvular leaflets) results in tricuspid stenosis (narrowing) or regurgitation (insufficiency)
- Tricuspid valve dysplasia leads to increased volume load on the right atrium and ventricle towards the end of diastole.
- A stenotic tricuspid valve can limit ventricular filling during diastole.
- Increased pressure as a result of increased volume can cause right-sided congestive heart failure.
Diagnosis
History & Clinical Signs
-Exercise intolerance
-Dyspnea
-Weight Loss
-Poor appetite
-Abdominal distension
Physical Exam
-Right-sided soft systolic murmur (tricuspid regurgitation)
-Right-sided diastolic murmur
-Jugular pulses & distension (severe case)
-Femoral pulses are normal to weak
-Signs of right-sided congestive heart failure (severe case)
Radiographic Findings
-Right atrial and right ventricular enlargement
-Caudal vena cava enlargement
-Pulmonary underperfusion
-Signs of right sided heart failure
Echocardiographic Findings
-Right ventricular and atrial dilation
-Abnormalities of tricuspid valve
Doppler shows tricuspid regurgitation and/or stenosis
Electrocardiographic (ECG)
-Classic signs of right atrial and ventricular enlargement
-Atrial arrhythmias
-Ventricular conduction problems
Treatment
Palliative Treatment
-Pharmacologically control right sided congestive heart failure
-Pharmacologically control arrhythmias
-Thoracentesis when needed to relieve pleural effusion
-Abdominocentesis when needed to relieve peritoneal effusion
Prognosis
Mild/Moderate Cases
-Normal life
Severe Cases
-Poor (However, if heart failure is controlled these patients can live several years.)