Version July 2025
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What is tricuspid regurgitation? —
Tricuspid regurgitation ("TR") is a condition in which 1 of the valves of the heart, called the tricuspid valve, leaks.
When the heart valves work normally, they keep blood flowing in only 1 direction. The valves work like swinging doors that open only 1 way: letting blood out, but not back in. The tricuspid valve normally keeps blood flowing from the right atrium to the right ventricle (figure 1). When it leaks, it lets blood flow back into the right atrium. Normally, little or no blood can leak backward. But if the valves are not working properly, more blood can go back in the direction it came from.
Many healthy people have a small amount of TR. But some people have larger amounts of TR, which can lead to problems.
What are the symptoms of TR? —
Many people have no symptoms. They might find out they have TR when their doctor or nurse hears a heart murmur on a routine exam. A heart murmur is an extra sound in the heartbeat that doctors hear when they listen to the heart with a stethoscope.
When TR causes symptoms, they can include:
●Swelling in the belly, legs, or ankles
●Belly pain
●A "pulsing" feeling in the blood vessels in the neck
If the TR is caused by another condition, people can have other symptoms. For example, TR can be caused by a condition called "pulmonary hypertension." This is high blood pressure in the blood vessels that carry blood to the lungs. Symptoms of pulmonary hypertension include feeling very weak or tired and having trouble breathing.
Is there a test for TR? —
Yes. Your doctor or nurse will ask about your symptoms, do an exam, and order 1 or more tests.
The most common test is an echocardiogram ("echo"). It uses sound waves to create pictures of the heart as it beats. It shows the size of the heart chambers, how well the heart is pumping, and how well the heart valves are working (figure 2).
Your doctor might also order:
●An electrocardiogram ("ECG") – This measures the electrical activity in the heart (figure 3).
●A chest X-ray – This can show the size and shape of the heart, as well as changes in the lungs.
How is TR treated? —
Treatment depends on your symptoms, how severe they are, and what's causing your TR. If your TR is mild or you have no symptoms, you might not need any treatment or follow-up. But even if you have larger amounts of TR, you might not need treatment. It's possible your doctor will simply want to wait and see if you end up needing treatment.
If your TR is severe and causing symptoms, you need treatment. This can include:
●Medicines or procedures to treat the cause of your TR, if it can be treated
●Medicines called "diuretics" – These help reduce swelling by making you urinate a lot.
●Surgery or a procedure on the valve – If medicines do not help enough, your doctor might need to repair or replace your tricuspid valve. This can be done as open heart surgery or by putting a thin tube called a "catheter" into a vein to get to your heart.
Patient education: Heart murmurs (The Basics)
Patient education: Swelling (The Basics)
Patient education: Pulmonary hypertension (The Basics)
Patient education: Echocardiogram (The Basics)
Patient education: ECG and stress test (The Basics)
Patient education: Heart failure (The Basics)
Patient education: Medicines for heart failure with reduced ejection fraction (The Basics)
Patient education: Prosthetic valves (The Basics)
Patient education: Edema (swelling) (Beyond the Basics)
Patient education: Heart failure (Beyond the Basics)
