Diagnosis of tricuspid valve insufficiency based on clinical signs and contrast echocardiography
Ruffmann, K.; Hess, O.M.; Krayenbühl, H.P.
Schweizerische Medizinische Wochenschrift 113(52): 1999-2003
1983
ISSN/ISBN: 0036-7672 PMID: 6665542 Document Number: 211285
The sensitivity and specificity of three clinical signs used for the diagnosis of tricuspid regurgitation (hepato-jugular reflux, congestion of the neck veins, inspiratory dilatation of the neck veins) were evaluated in 27 patients by contrast echocardiography. Tricuspid regurgitation was diagnosed when regurgitation of microbubbles into the inferior vena cava occurred at the time of the v-wave of the atrial pressure pulse. Nine of the 27 patients had tricuspid regurgitation (group I) and 18 patients (group II) did not. The end-diastolic diameter (group I: 3.1 cm; group II: 2.4 cm; p less than 0.05) and the end-systolic diameter (group I: 2.9 cm; group II: 2.3 cm; p less than 0.05) of the vena cava inferior were larger in the patients with tricuspid regurgitation than in those without. The end-diastolic short axis of the right ventricle (group I: 3.5 cm; group II: 3.2 cm; n.s.) did not differ significantly between the groups. Within group II, the echocardiographic dimensions of the vena cava inferior and the right ventricle did not differ in patients with congestion of the neck veins from those without. A significant correlation between clinical signs and tricuspid regurgitation could only be demonstrated for the hepato-jugular reflux (p less than 0.01, chi 2-test) and for inspiratory dilatation of the neck veins (p less than 0.05, chi 2-test).